By Jeff Stewart – Podiatrist (B.Pod La Trobe, M.A.Pod.A NSW) | Manly Cove Podiatry
It is one of the most common concerns I hear from parents at Manly Cove Podiatry: they have noticed their child’s feet look flat when standing, and they are not sure whether to be worried. The short answer is that flat feet in children are extremely common and, in most cases, a completely normal part of development. But not all flat feet are the same, and there are situations where an early assessment makes a real difference.
Here is what you need to know.
Flat Feet Are Normal in Young Children
All babies are born with flat feet. The arch is not yet formed – there is a pad of fat under the foot that fills the space where the arch will eventually develop, and the ligaments and muscles are still quite loose. As children start walking and becoming more active, those structures gradually strengthen and the arch begins to form.
For most children, a visible arch develops somewhere between the ages of three and six. By around six to eight years old, a child’s foot posture is broadly similar to what it will be as an adult. So if you are looking at the feet of a toddler or young child and thinking they look flat – that is most likely exactly where they should be developmentally.
It is also worth knowing that around one in five people never develop a fully formed arch. Flat feet in adults are common, and many people with flat feet have no pain or problems at all throughout their life.
Flexible vs Rigid Flat Feet – The Key Distinction
The Simple Test You Can Do at Home
The most important thing a podiatrist looks at when assessing children’s flat feet is whether they are flexible or rigid. Ask your child to stand on their tiptoes. If an arch appears, the flat feet are flexible. If the foot stays completely flat, it is worth getting it checked.
What Each Type Means
Flexible flat feet show an arch when the child is sitting, on tiptoe, or not bearing weight – but the arch flattens when they stand. This is the most common type and, in most cases, benign. Many children with flexible flat feet have no pain and need no treatment at all.
Rigid flat feet remain flat in all positions – sitting, standing, on tiptoe. This can indicate a structural issue, such as two foot bones being fused together (a condition called tarsal coalition), and is more likely to require attention from a children’s podiatrist.
Signs It Is Worth Getting Checked
Flat feet on their own are not automatically a cause for concern. But it is worth booking an assessment if your child:
- Complains of pain in their feet, heels, ankles, knees, or legs
- Gets tired much more quickly than other children during physical activity
- Avoids sport, running, or physical play – or frequently asks to be carried
- Has an awkward walking pattern, trips often, or walks with feet turned out
- Has feet that stay flat even on tiptoe
- Is over six years old and still has noticeably flat feet
- Has a family history of flat feet with pain or lower limb problems
What Causes Flat Feet in Children on the Northern Beaches?
Developmental and Genetic Factors
For most children, flat feet are simply part of normal development with no specific cause. Beyond that, the most common contributing factors include genetics – flat feet often run in families – and hypermobility, where naturally loose ligaments and flexible joints reduce the structural support available to the arch.
Tight calf muscles are another common factor. Limited ankle range of motion increases the load through the arch and can contribute to a flatter foot posture over time.
The Active Northern Beaches Lifestyle
Across Manly, Freshwater, Seaforth, and Balgowlah, we see a lot of active kids – sport, surf club, beach activities, running around at school. That is generally a great thing, but it does mean foot mechanics get tested early and often. If there is an underlying issue with a child’s flat feet, higher activity levels tend to bring it to the surface sooner rather than later.
Does It Matter If Children’s Flat Feet Go Unaddressed?
When It Is Fine to Monitor
For children with flexible, painless flat feet, the answer is often no – many will continue through childhood and into adulthood without any problems at all. Observation and monitoring is a perfectly appropriate approach for many children, and we will always say so if that is the case.
When It Is Worth Acting Earlier
For children whose flat feet are causing symptoms, or where the foot structure is putting abnormal load on other parts of the lower limb, leaving it unaddressed can have consequences. Flat feet that cause the foot to roll inward can affect alignment all the way up the leg – contributing to knee pain, shin pain, and hip discomfort.
We also see children developing heel pain (Sever’s disease), Achilles tightness, and fatigue-related pain that traces back to flat foot mechanics. Catching these things earlier generally means simpler treatment and faster resolution. For kids playing sport at Manly, Queenscliff, or Freshwater surf clubs, or competing in school athletics across the Northern Beaches, getting on top of it early keeps them active.
What to Expect at a Children’s Flat Feet Assessment in Manly
How We Assess Your Child
When a parent brings a child in to Manly Cove Podiatry with concerns about flat feet, the assessment is straightforward and non-invasive. We take a history – when did you notice it, any pain, any family history – then carry out a thorough physical examination.
We look at the foot structure both weight-bearing and non-weight-bearing, check ankle and calf flexibility, and assess how your child walks and how the lower limb is loading and moving. We also look at footwear, which is often a significant factor in both symptoms and progression.
Treatment Options
In many cases, the outcome of an assessment is simply reassurance – the feet are developing normally and no intervention is required. Where treatment is appropriate for children’s flat feet, options include:
- Footwear advice – often the most straightforward starting point
- Stretching and strengthening exercises – particularly for tight calf muscles
- Prefabricated orthotics – practitioner-grade, assessed and adjusted in-clinic to suit your child’s specific needs
- Custom orthotics – for more complex presentations where prefab devices are not providing sufficient correction
Treatment is always conservative and age-appropriate. For younger children especially, we take a minimum effective intervention approach – we do what is needed and no more, and we review as the child grows.
At Manly Cove Podiatry, we see children of all ages – from toddlers taking their first steps through to teenagers managing sports load on the Northern Beaches. If you have any concerns about your child’s feet or the way they are walking, a children’s podiatry assessment is the best next step. Even if everything turns out to be perfectly normal, the peace of mind is worth it.
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Book online: manlycovepodiatry.com
Call us: (02) 8966 9552
Saturday appointments available – no referral needed
