flexible flat feet treatment

Flexible Flat Feet

Information for Families – Flexible Flat Feet

What are flexible flat feet?
Most feet have an arch on the inside of the foot; however, some children have flexible flat feet, also known as fallen arches or pes planus. All babies and most toddlers appear to have flat feet due to their “baby fat” which hides the developing arch. Flat feet are considered normal at these developmental ages. The feet are called flexible because the arch reforms when your child goes up on tip-toes. (see picture) It can be common for other members of your family to have flat feet.

What is the cause?
The incidence of flat feet is the same in populations of people who wear shoes and those who don’t wear shoes. Softening of the ligaments that hold the bones together causes flexible flat feet.

What problems can occur?
Most children with flexible flat feet do not have any symptoms. Historically, the army would reject soldiers with flat feet; however it is now known that people with flat feet have the same chance of having foot problems as people with arched feet.

What treatment will be required?
There is no treatment usually needed for the vast majority of children with flexible flat feet. The use of shoe inserts / insoles (orthotics) is not recommended, as these have been found to have no effect on the development of the arch. Orthotics are only used for older children who have pain in their feet, which is a very small percentage of the children we see with flexible flat feet. We recommend that the right shoes for your child fit correctly and are comfortable.

What is the natural history of a child with flexible flat feet?
The arch on the inside of the foot may begin to develop at age 4 and should be developed by age 10. If not, your child is likely to have flat feet in adult life, however again there is no evidence to say they will have more problems than a person with an arch. There are numerous sportsmen and sportswomen and professional dancers with asymptomatic flat feet


• Most children with flat feet will not need treatment

• Orthotics (insoles) do not help the development of an arch in the foot any better than a child’s natural growth

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