No, children do not magically ‘disappear’ from flat feet. Treatment is key to avoiding long-term pain

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Every day, parents around the world are told that their children’s flat feet are normal and that they will grow out of it. This is not true, they just grow out of their pediatricians’ practice. There is no evidence that flat feet in children correct themselves over time.

Failure to intervene when problematic flat feet are identified is detrimental to the child. Research shows they don’t get better and usually get worse. Most flat feet can be corrected at a young age. But when left untreated, they make it difficult to child developmentthey put adverse pressure on your feet and the rest of your body, resulting in permanent adverse structural change.

This can cause and aggravate lifelong problems with your posture.

A child’s flat feet should be treated early, aggressively, and for as long as necessary to achieve correction. The feet do not deflate. Experts agree that painful flat feet in adults usually arise from pre-existing flat feet in childhood. Children rarely complain of foot pain because their bones are soft and forgiving and their body weight is low, causing minimal stress. However, they complain legs, knees and growing pains.

Some also begin to avoid physical activity. Many parents say that their child will not stand up no matter how many times they are reminded. Once they get older, they may not experience pain until their teens or twenties, or earlier if stress increases, such as participating in sports. The claim that flat feet in children resolves spontaneously is not supported by any long-term studies. In contrast, there is published data suggesting that flat feet in children become flatter over time, eventually leading to painful flat feet in adults.

The reason many doctors claim that children’s flat feet improve was originally based on a 1957 study that evaluated the relationship between the width of the heel and the arch of two- and ten-year-old children. The authors found the width of the foot reduced by 4% in relation to their age. They concluded that this meant that flat feet would resolve within ten years.
But their data didn’t take into account the alignment of the child’s bones, and the results weren’t strong enough to conclude that flat feet resolve over time. And it wasn’t a long-term study.

Children with flat feet also have a lower quality of life and a higher body mass index (BMI) compared to their peers.
Research confirms that flat feet cause abnormal stress and movement compensations, leading to more problems and pain in the knees and hips as children move into adulthood.

The benefits of early intervention

Justin Greisberg MD, orthopedic surgeon and chief of the foot and ankle service at Columbia University Irving Medical Center, said the most important treatment for adult flatfoot is prevention. If the foot at risk can be identified, early intervention could prevent the deformity. Merely observing a child’s flat feet from time to time without intervening (as some physicians and podiatrists do) is a clinical error and makes further treatment difficult or impossible.

Early intervention encourages the development of correct foot shape in a way similar to, say, getting braces for your teeth. This idea has been used successfully for decades in correcting other foot posture problems, such as clubfoot. This does not mean that all flat feet need to be treated, but those that have the potential to become problematic should be immediately identified by a trained physician.

Occasionally, monitoring a child’s flat feet causes the condition to develop and become infected, causing it to not respond to further treatment. This approach also contradicts research that shows early treatment is key to successful outcomes. Treatments may include braces, strengthening exercises, ballet, and surgery.

In children’s flat feet, we are dealing with a complex array of loose ligaments, young muscles and nerves, and an immature and misaligned skeletal system. It is from this framework that children derive the structure and function of their adult foot. Lack of intervention is a lack of recognition of the long-term consequences of excessive flat feet, not just on the feet but throughout the body.

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