We frequently anticipate youngsters to be naturally active, running, jumping, and playing. So, when a child complains of foot pain or appears to tire easily, it's tempting to dismiss it as a temporary symptom. However, in recent years, there has been a dramatic increase in something we should not ignore: flat feet and postural collapse in youngsters.
Flat feet, known medically as pes planus, are not usually cause for concern in newborns and toddlers. However, when the foot arch fails to grow properly, or when youngsters exhibit joint laxity, pain, or bad posture, it may indicate a more serious musculoskeletal issue that requires care. We spoke to Dr Saraswati V, Consultant - Paediatrician Orthopaedics, Gleneagles BGS Hospital, Kengeri, Bengaluru, who explained flat feet and postural collapse in children.
Understanding Flat Feet: What is Normal and What is Not?
“Every baby is born with flat feet. That's perfectly normal. Their arches normally form between the ages of two and six, as the foot's muscles and ligaments develop. However, in some youngsters, this development does not proceed as planned,” said Dr Saraswati.
According to a 2024 study, the foot's arch is made up of ligaments, tendons, muscles, and bones that work together to support the body's weight and maintain stability while walking and engaging in other physical activities. In people with flat feet, the ligaments and tendons become weakened, leading to a collapse of the arch.
There are two primary types of flat feet, including:
- Flexible flat feet, with an arch apparent when the kid is not bearing weight but disappearing when standing.
- Rigid flat feet, which lack an arch even when not bearing weight, are more problematic and may indicate underlying joint or bone issues.
“The true problem emerges when flat feet are accompanied by discomfort, imbalance, changed gait, or changes in posture. If left untreated, these can impair a child's entire kinetic chain, including the ankles, knees, hips, and even the spine,” added Dr Saraswati.
Also Read: Living with Flat Feet: Practical Tips for Managing Pain and Discomfort
Why Are We Seeing More Cases Now?
The increase in postural difficulties among children is not merely anecdotal; it is being observed in clinics. There are several contributing factors:
- Sedentary lifestyles: Today's children spend significantly more time indoors staring at screens than playing barefoot or being physically active. Foot muscles do not receive the stimulation they require to strengthen.
- Poor footwear: Many commercial shoes for children prioritise style over support. Flat soles, inadequate arch support, and poor heel control can all lead to foot misalignment.
- Obesity and joint laxity: Excess weight puts strain on developing joints, and certain youngsters are naturally more hypermobile, which predisposes them to collapsed arches.
- Delayed diagnosis: Frequently, parents are encouraged that 'they'll grow out of it.' In certain situations, they do. "However, by the time a serious problem is noticed, such as knee discomfort, trouble running, or poor balance, compensatory alterations may have already occurred further up the musculoskeletal system.
The Domino Effect: How Feet Affects the Whole Body
Our feet serve as the foundation for proper posture. When the foundation is unsteady, the impacts spread upward. Children with untreated flat feet may have:
- Knee Valgus (knock knees)
- Internal Hip Rotation
- Lower back strain
- Frequent tripping or clumsiness
- Fatigue from physical exercise
In clinical terminology, this is commonly referred to as postural collapse. The child doesn’t just have flat feet; they have an abnormal alignment, which may have long-term implications for movement quality and joint health.
What Signs Should Parents Look Out For?
Not all flat feet require treatment. However, certain red flags should prompt a consultation with a paediatric orthopaedist.
- Complaints of foot, ankle, or leg pain
- Early weariness from sports or walking
- Visible misalignment of the knees and feet
- Uneven shoe wear
- Frequently stumbling or lacking coordination
- Difficulty standing for extended periods
A physical examination, sometimes in conjunction with X-rays or gait analysis, can assist in evaluating whether the flat foot is part of a greater postural problem.
Also Read: Not Everyone With Flat Feet Experience Pain And Other Myths About Flat Feet Debunked
When, and How to Treat
The treatment strategy is determined by the severity of the symptoms and the underlying cause.
- Activity-based therapy: For many children, systematic physiotherapy focusing on strengthening foot and leg muscles can be extremely beneficial. Activities, such as toe walking, balance games, and barefoot play on uneven surfaces can help enhance arch function.
- Orthotic inserts: Custom arch supports may be prescribed for children with symptoms. These do not 'cure' flat feet, but they do assist in straightening the foot, relieve strain, and increase comfort.
- Footwear changes: Wearing supportive, well-fitted shoes with strong heel counters and flexible soles improves posture and gait mechanics.
- Surgical correction: In extreme situations, particularly those with inflexible deformities or bone coalitions, surgery may be recommended. But this is usually a last resort.
Prevention Begins Early
We cannot emphasise this enough: healthy feet are formed in early childhood. Allowing children to play barefoot on safe surfaces, promoting active play, limiting screen time, and selecting supportive footwear can all help prevent postural disorders.
A musculoskeletal screen should be included in routine paediatric examinations, especially for children who have known ligament laxity, a family history of flat feet, or other symptoms.
Message From The Expert
Dr Saraswati concluded, “Flat feet in youngsters are not often an issue, but when they are, they should not be overlooked. As medical experts, we are noticing an increase in the number of young patients whose posture, movement, and confidence are being negatively impacted by untreated foot and gait disorders. With prompt attention, most children can restore full, pain-free function without invasive therapy.
Early intervention is not intended to cause concern; rather, it is intended to preserve movement, prevent long-term harm, and ensure that every child has a firm, stable foundation on which to stand and thrive.
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]