MY CHILD HAS FLAT FEET ..... TO TREAT OR NOT TO TREAT??

MY CHILD HAS FLAT FEET....TO TREAT OR NOT TO TREAT??

Much controversy exists among medical specialists and parents of children with "flat feet." As there is much debate in the medical literature whether treatment of children with a non-painful, but an obvious and visible flatfoot deformity can prove beneficial.
A normal foot can be described as one having an arch, which is that space between the big toe and the heel on the inside of both feet. This area should be elevated off of the ground while standing, and shaped like a cave or arch. There should be enough space there that you could slide a couple of fingers underneath of your foot, as if your fingers are entering the 'cave.' This gentle curvature of the arch is also visible while the foot is off of the ground/not standing or walking. Those individuals with flatfeet are missing that cave or arch, and this side of the foot touches the ground, sometimes so incredibly flat that the foot actually makes a suction-type sound with every step! In extreme cases, the arch is so collapsed that one may walk on the inside of the ankle!
Depending on the severity of the flatfeet, there are many treatment options. Options include, in specific cases, serial casting (a series of casts applied over time to babies in hopes of correcting the deformity), over-the-counter arch supports or custom orthotics, and surgical reconstruction in the most painful & deformed cases.
A common misunderstanding is that All flatfeet should be treated with arch supports or custom orthotics. This is false. The most import consideration is age of the patient. Many parents present to the pediatrician or podiatric surgeon requesting orthotics for their child's flatfeet. Newsflash! Childrens' feet appear flat until the age of 4 or 6! Prior to, the arch is not fully developed, and often masked by "baby fat.'' It is not uncommon for parents to begin noticing and become concerned about the flattened appearance of the feet during this time. Parents being parents, present their complaint, and oftentimes their children are prescribed orthotics without a flatfoot deformity at all. We end up 'treating the parents,' when orthotics were not necessary to begin with, disrupting the natural growth of the soft tissues and bones in the child's foot, which could prove detrimental in the future.
Next we enter children after age 6, when the arch begins to appear. During this age, usually, either the children are complaining of pain in the arches during and/or after play, OR, parents notice the flattened appearance of the foot. Over the counter inserts or custom orthotics would of course be indicated in the children complaining of pain. And in the most extreme cases, surgery. But what about those without pain, but with obvious flatfeet?? This is where it becomes tricky. An important question to ask is "Does mom or dad, brothers or sisters, grandmother or grandfather have flatfeet? Any were these flatfeet problematic?" Flatfeet are hereditary. If there is a relative with symptomatic flatfeet, then the likelihood of the child developing symptomatic flatfeet is increased. However, that is Not Always the case. There is some medical literature that supports custom orthotics to stop the progression of flatfeet in children. It is certainly worth a try!
Some children have SEVERELY painful flatfoot deformities that require surgical reconstruction for pain-relief. These cases are few and far in between, but do exist in every podiatry practice.
In summary, some of the most famous professional athletes have flatfeet. Some of them are painful, others are not. Some need treatment, others do not. The decision is purely individual in each case. The answer cannot be found in any medical journal, informational blog or reading material. If there is a concern, the child needs to be examined.
To have your child examined for the severity of their flatfeet, email Dr. Malinoski via her website at www.podiatristofnaples.com