Flat Feet

At Masterton Foot Clinic, we don't assess children simply because their feet look flat. Our role is to determine whether their feet are functioning well, whether they are causing symptoms, and whether treatment is likely to provide meaningful benefit.

What are flat feet?

Children are born with naturally flat feet. As they grow, the muscles, ligaments, bones, and joints of the foot continue to develop, and many children gradually develop a more visible arch throughout childhood.

Some children retain flatter feet into adolescence and adulthood. In many cases, this is simply a normal variation of foot shape and does not require treatment.

The most common type is known as a flexible flat foot, where the arch appears when standing on tiptoes or when the foot is not bearing weight. This differs from a rigid flat foot, which is much less common and may require further investigation.

When should parents be concerned?

Rather than focusing solely on the appearance of the foot, we consider whether it affects your child's comfort, movement, or participation in everyday activities.

We recommend an assessment if your child:

• Complaints of foot, heel, ankle, leg, or knee pain.
• Trips or falls more often than expected for their age.
• Tires more quickly than other children during walking, running, or sports.
• Avoids physical activity because of discomfort or fatigue.
• Has difficulty keeping up with their peers.
• Wears their shoes unevenly or unusually quickly.
• Has one foot that looks significantly different from the other.
• Has a foot that appears stiff or rigid.
• Has a known neurological, muscular, or inherited condition affecting their lower limbs.

For many children with painless, flexible flat feet, reassurance and monitoring are all that is required.

Can flat feet affect other parts of the body?

Your child's feet and legs work as one connected system.

Almost every muscle in the lower leg attaches to the foot, helping to support the arch and control movement during walking and running. Changes in foot posture can therefore influence how forces are transferred through the ankles, shins, knees, hips, and lower back.

This does not mean every child with flat feet will develop problems. However, when symptoms such as pain, fatigue, tripping, or reduced participation occur, assessing the entire lower limb often provides valuable information about why those symptoms are developing.

Rather than treating the appearance of the foot, we aim to understand how your child's feet are functioning and whether they are contributing to the problems you have noticed.

How we assess children's feet

Every child is different.

Our assessment looks well beyond the shape of the arch and may include:

• Walking and running assessment
• Balance and coordination
• Foot and ankle mobility
• Muscle strength
• Joint flexibility
• Footwear assessment
• Shoe wear patterns
• Functional testing appropriate for your child's age
• Assessment of pain, fatigue, and activity levels

Most importantly, we determine whether your child's feet are functioning appropriately for their age and whether any intervention is likely to improve comfort or participation.

How we treat children's flat feet

At the time of writing, current evidence suggests that many children with painless, flexible flat feet do not require treatment.

When intervention is appropriate, our aim is to improve comfort, function, confidence, and participation rather than simply changing the appearance of the foot.

Depending on your child's needs, treatment may include:

• Education and reassurance
• Footwear advice
• Activity advice
• Strength and balance exercises
• Foot Mobilisation Therapy (FMT), where appropriate
• Custom Foot Orthoses where appropriate
• Ongoing monitoring during growth

Treatment is always individualised. Not every child requires Custom Foot Orthoses, and not every flat foot needs to be corrected.