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Flat Feet in Children
(by Gena Livingston - February 05, 2010)
Flat foot also known as pes planus, is a condition where the inside of the foot lacks an arch. This is one of the most common foot deformities affecting approximately 25% of the U.S. population affected. Some people with flat feet may experience problems that limit their activities, while others are competitive athletes. It is important to differentiate a normal flexible flat foot from other serious foot problems. A rigid flat foot is a more serious problem that is often caused by a bony deformity such as a fusion of one or more bones of the foot. An orthopedist or podiatrist can appropriately diagnose the type of foot deformity. The good news is that the vast majority of children do not have a fixed deformity and require only conservative treatment.
All children are born with flexible flat feet, a condition in which the arch of the foot shrinks or disappears when they stand. Most children eventually develop a normal arch, however some do not. When a child’s flat foot posture persists between the ages of six and ten, it indicates a permanent condition. At this time immediate intervention is recommended to encourage normal development of the arch and to prevent pelvic and spinal postural deformities. This is especially true when one foot is flatter than the other. Unbalanced forces occurring during physical activity can result in significant trauma to the foot/ankle, knees, hips and back.
A pediatric physical therapist should evaluate the child with flat feet in order to assess the flexibility of the Achilles tendon, degree of pronation, strength of the tibialis posterior muscle and determine the need for custom made orthotics. Children with flat feet often exhibit tight calve muscles or Achilles tendons that need to be stretched. When the Achilles tendon is tight, it causes the foot to drop down or plantarflex. The body tries to compensate by pronating or flattening the inside of the foot. In addition the child may demonstrate weakness of one or more of the muscles in the calf including the tibialis posterior muscle. Along with stretching, exercises and manipulation, orthotics are another component of the treatment. At Kids Therapy Center we coordinate care by a licensed orthotist who is able to create molds for the foot in the convenient setting of our clinic. The use of orthotics provide corrective support that encourages normal development while preventing further deformity and reducing abnormal kinetic chain stresses on the pelvis, and spine during the formative years. Surgery is rarely required for this condition and is reserved only for the severe types of flat foot that do not respond to conservative therapy.
Gena Livingston is a pediatric physical therapist, who brings over five years of experience to Kids’ Therapy Center™ of Riverdale. Specializing in early childhood intervention, Gena is very experienced treating children with cerebral palsy, delayed motor development, autism, torticollis, post-surgical corrections, and athletic injuries. If you would like to schedule an appointment or consult with Gena, she can be reached at Kids’ Therapy Center™, 18 Newark Pompton Turnpike, Riverdale, 973-616-8300.
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