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Should I be worried if my child has flat feet?

Family Health, Orthopedics
Oct 12, 2017

Podiatrist Samuel Hall addresses stages of flat foot and treatment options

Have you ever taken a good look at your feet or your child’s feet? Most probably seem pretty normal. However, there’s a large population of youth and adult Americans who have a condition called flat foot. For some, it never bothers them, but others may experience a lifetime of foot pain unless they seek treatment. 

Flat foot is a condition in which the arch of the foot collapses and the entire sole of the foot completely or nearly completely touches the ground upon standing.  The arch falls when tendons in the foot get stretched out and do not pull properly together, resulting in little or no arch.

Flat foot is mostly a heredity condition, says Samuel Hall, DPM, podiatrist at Georgia Foot & Ankle Institute. However, other factors may cause flat feet including obesity, trauma and some health conditions such as rheumatoid arthritis and diabetes.

Some people will never experience symptoms of flat feet, while others may have pain in their arch or the inside of the ankle. Pain can be the result of lots of running or walking or continuous standing.

Dr. Hall says flat foot is one of the more common podiatric issues people complain or worry about, especially parents regarding their children.

“Most children have flat feet because their bones aren’t completely formed yet,” Dr. Hall says. “If your two-year-old is walking around and it looks like they have flat feet, they do have flat feet but it’s normal.”

If parents are concerned about their child’s feet or the child is experiencing arch or other foot pain, Dr. Hall encourages them to schedule an appointment. For children under the age of nine, podiatrists will do what they call “watchful waiting” to monitor foot growth and assist with pain management if pain exist. Surgery isn’t performed on children that young because bones are still growing and the arch hasn’t developed yet.

When kids get around the ages of 9 or 10, doctors have a better idea of the foot’s structure. If a child is experiencing flat feet and pain, podiatrists can suggest orthotics or inserts. Another option is a minimally-invasive procedure that inserts a screw-like implant, called a MBA implant, into the sinus tarsi, a small, bony canal near the ankle. The implant helps realign the foot and promotes the arching of the foot.

The implant is only for adolescents, Dr. Hall says, and will be removed by the age of 18 because it has served its purpose at that point.

“If your kid plays sports and is constantly complaining of arch or other foot pain, and they do potentially have a flat foot, we can put in an implant,” Dr. Hall says. “We won’t do foot reconstruction surgery on someone that early in life, but the implant can help, and it’s a simple procedure.”

Flat foot in adults

Adults also experience flat feet, even those who may have had a MBA implant as a youth. The Institute for Preventive Foot Health estimates more than 26 million adults have flat feet or falling arches.

The degree of flat feet is based on stages. There are four stages. Stages one and two typically can be treated outside of surgery. Here’s a look at the stages:

  • Stage 1: A patient may experience pain along the heel, arch or ankle but there is minimal deformity or collapsing of the arch. Treatment options include orthotics, inserts and proper shoe gear.
  • Stage 2: The collapsing of the arch is more noticeable and patients are likely to experience weakness in the arch and pain. However, the foot is still flexible. Minimally-invasive soft tissue procedures can help repair damage and control pain.
  • Stage 3: The deformity has progressed to the point where the foot becomes rigid and will no longer come back to a normal foot. This requires soft tissue repair and reconstruction surgery of the arch.
  • Stage 4: In addition to a completely collapsed, rigid arch, deformity in the ankle begins, requiring surgery for both the foot and ankle.

“Many people think, ‘I’ve always had flat feet. There is nothing anyone can do.’ But there are things we can do,” Dr. Hall says. “A lot of people may not want to undergo reconstruction because you are down for an extended period of time. If you don’t want to opt for surgery, there are also conservative treatment options that are beneficial. We can improve flat feet and improve the quality of your life.”

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