Flexible Flatfoot in Children

Flexible Flatfoot, or Pes Planus, is a condition that causes the arch of the foot to temporarily collapse. The arch is not visible when the child stands and re-appears while sitting or when the foot is left hanging freely. The condition may be congenital and affects both the feet. In most cases, it gets resolved as the child attains the age of 5 years. It is considered serious if the child feels pain or does not develop an arch even after this age.

Flexible Flatfoot usually does not hinder the foot’s movement or ability of the child to participate in physical activities. With the growth of the bones and soft tissue structures, the child tends to develop a normal arch.


  • Flexible Flatfoot may be an inherited problem
  • A tight Achilles tendon may cause the arch to collapse


  • Pain may be felt at the base of the foot or near the arch
  • Visibly flattened foot while weight bearing
  • Altered gait
  • The child may complain of stiffness or tiredness after a physical activity. He may also feel pain in the legs and knees
  • Shoes may be worn out on the inner side due to the inward tilt of the foot (overpronation)


  • Detailed examination of the feet to check if the collapse of arch is rigid or flexible
  • Details of the family history may be taken into consideration
  • The doctor may ask the child to stand on toes, sit, walk or stand to check for the deformity
  • X-ray examination may be required to check the bone structure and condition of the Achilles tendon besides other soft tissue structures


Treatment for Flexible Flatfoot generally includes conservative methods. Some of them are:

  • Use of orthotic devices or shoe inserts can help in maintaining the arch and relieving the pain
  • Specific stretching exercises may be practised for eliminating the symptoms and improving the functionality of the joint
  • Physical therapy sessions may help to reduce the tightness in the Achilles’ tendon and improve the foot biomechanics
  • Surgery may be recommended if the condition worsens or persists beyond adolescence. It may be done to relieve the tight Achilles tendon
  • Surgical lengthening of the heel bone using a bone graft may be required in some cases

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