The first few weeks of school are always difficult for children transitioning from the lazy days of summer to the rigorous schedule of classes and extra-curricular activities. But if a child seems more sedentary than usual, it might be something more than fatigue. About 20 percent of children have flat feet, which can cause foot and ankle pain, night cramps, pain when walking or lower back and knee pain.

If this is the case, said Temple University podiatrist Kieran T. Mahan, a child might withdraw from activities and can become more and more inactive.
While flexible flat feet are very common and usually require little to no treatment, rigid flat feet can be painful and can cause posture problems.

Many times, flexible flat feet stem from metatarsus adductus, a sharp, inward angle of the front half of the foot. It can occur as a result of a child’s intrauterine position, where feet are bent inward. When a child with metatarsus adductus puts his or her foot into a normal shoe, the foot attempts to straighten out by flattening the arch.

Rigid flat feet can stem from tarsal coalition, a condition in which two bones in the foot fuse together as it grows, and can limit movement.
Mahan also noted that the rise in childhood obesity has also increased the instances of flat feet.

“As the foot adjusts to balance weight equally, it can put pressure on the arch and cause it to fall,” he said. Changes in the foot arch affect ankle and knee function, and when the foot collapses entirely it causes instability, leading to gait and posture problems.

“With flat feet, it is the instability of the foot that creates the problems. Many people can have a low arch without having a problem. We use a particular approach with bone grafting and tendon balancing that stabilizes the foot while preserving flexibility,” he said.

While Mahan says that only a small amount of cases need surgery, he stressed the importance of early treatment through the use of devices like orthotics, shoe inserts that are intended to correct an abnormal walking pattern, to avoid trouble later in life.

All babies and toddlers have flat feet, caused by loose ligament joints and baby fat between the foot bones. In about 80 percent of children, foot arches form by age 10.

Prior to starting the new academic year, many elementary schools recommend or require children to have a complete physical from their pediatrician. Mahan suggests using this visit to check for the presence of flat feet.

“A pediatrician will notice flat feet right away, and can send parents to a podiatrist for treatment,” said Mahan.

Mahan diagnoses and treats flat feet in the Gait Lab at Temple’s School of Podiatric Medicine, where advanced 3-D technology measures patients’ stride, pressure, movement and posture.

Without the proper diagnosis, Mahan said, flat feet can get progressively worse. “If it’s not treated properly, children can suffer from flat feet into adulthood. When this occurs, the foot can totally collapse and can create a disability,” he said, noting that it can affect the quality of life. “People want to stay active as long as possible.”

Source: Temple University