A flat foot is a condition in which the arches of the feet are flattened out so that the entire sole of the foot touches the ground. A normal, newborn baby does not have arches of the feet. (The normal condition of a child’s feet before arches develop is sometimes called “physiological flat feet.”) Arches don’t start to develop until the child begins to walk unaided. They are not fully formed until the child is three to four years old. Arches are formed by the developing strength of the leg muscles exerted on the normal bones and ligaments of the feet.
Signs and symptoms
With true flat feet, there are no arches when a child stands. The child walks on the inner edges of the feet. This practice breaks down the tops of the shoes from the inside and wears down the inner edges of the heels and soles on the shoes. The child may complain of painful feet after brief exercise.
The presence or absence of an arch at any age can best be judged when a child stands, on the tips of the toes. After age three or four, your child should no longer wear out the inner edges of the shoes.
Home care
To encourage development of the feet, children should not wear walking shoes until they start to walk unaided on hard surfaces. If a child under three or four years of age breaks down the upper portions of the shoes or wears out the inner edges of the heels before the shoes are outgrown, buy shoes with stronger counters (the inner part of the back third section of the upper shoe). If your child past age three appears flat-footed, have the child tiptoe barefoot five to ten minutes per day. A child over six to eight years of age should walk barefooted on the outer edges of the feet with the toes clenched for ten minutes daily.
Precautions
• Do not use orthopedic shoes or devices without competent professional advice. Orthopedic shoes are expensive and if not needed, they actually may harm normal feet.
• Painful feet after excessive use and exercise do not indicate abnormal feet.
Medical treatment
Your doctor will examine your child’s feet carefully while the child stands, sits, stands on tiptoes, and walks. The doctor will conduct tests for the movement of the joints of the feet, the strength of the foot muscles, and the strength of the tendons. Your doctor will examine worn shoes. Rarely will the doctor X ray your child’s feet. Considering all these factors along with the child’s age, the doctor may prescribe exercises or orthopedic shoes.
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