Video Explanation: Flatfoot – What Parents Need to Know

Flatfoot is one of the most common conditions that brings parents to the pediatric orthopaedist. It's characterized by a flattening or absence of the medial plantar arch, that natural curve on the inside of the foot. **Important to know:** All children are born with flat feet! The plantar arch develops gradually between ages 3 and 6-8. Before this age, the presence of fat tissue in the sole and physiological ligament laxity give a "flat" appearance that is completely normal. **Flexible vs rigid flatfoot:** The fundamental distinction is between flexible flatfoot (most common, benign) and rigid. In flexible flatfoot, the arch disappears at rest but forms when the child rises on tiptoes. In rigid flatfoot, the arch never forms and the foot may be painful - this form always requires thorough evaluation. **Orthotics: yes or no?** This is the most frequent question. Current scientific research indicates that orthotics don't "cure" asymptomatic flexible flatfoot in children. They may be helpful in the presence of pain, fatigue, or abnormal shoe wear, but the decision must be individualized. **Rigid "orthopaedic" shoes** are a thing of the past. Children benefit from flexible shoes that allow the foot to move naturally. Walking barefoot, when possible and safe, promotes foot muscle development.