When do children’s feet develop arches and do they need insoles for their flat feet?

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I was recently a part of a podcast where I got the chance to discuss all things children’s feet with 5 other great podiatrists from Australia and the UK. A common case study was posed to us regarding children’s flat feet and the use of insoles as treatment. This is a frequent presentation in the clinic from concerned parents however what was unexpected yet not unanticipated was the collective sigh and slight smile at the proposed case study. This is due to the battle against scare campaigns on social media by non-health professionals, and unfortunately some health professionals regarding the need to “fix” children’s flat feet.

Parents should be aware that the development of the child’s foot is ongoing from the time they are born until late teens or even early ’20s. Infants are born with a lot of soft tissue and not a lot of fully formed bone in their feet. The have a nice little fat pad that sits under their arches that give the appearance of a flat foot. Yes as toddlers their feet will roll inwards however this is expected given they have not yet fully developed the bony framework or the muscle strength to withstand the forces above it. The body goes through fascinating changes; babies legs are bowed and then they become knock-kneed three to five years, they can by more in-toed or pigeoned toed at first and then this can resolve, the way they walk will changes over these years as their body and motor skills develop and this will place different pressures on the feet. I was lucky enough to be in a working party for the Australian Podiatry Association where we developed some really good resources for the Better Health Channel to provide parents to guide them through the changes their children will go through.

As far as I’m aware foot orthotics or insoles are not like orthodontic braces for teeth, they do not align and maintain a position after they are removed. But have I prescribed orthotics or insoles for flat feet in children? The answer is yes. But only when clinically indicated at a specific time in a child’s life and for a specific reason. At times some children need assistance to learn to stand independently and walk, learn a new skill or if they have pain in their legs or get tired easily. This is assessed on an individual basis with a plan in place form them to be removed and in consultation with other therapists, you have in your time. Although most of the time good footwear is all that is needed.

If you have any further questions or concerns, organise a brief, no charge online telehealth/virtual appointment with myself to discuss if your infant, toddler, child, or adolescent son or daughter requires a consultation. Feel free to email me directly to book a time antoni@ajcpodiatry.com.auajcpodiatry.com.au or via Lefort Podiatry and Fairfield Podiatry where I offer face to face & online consultations.

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Antoni Caserta

Antoni Caserta

Antoni’s private practice and public work focuses on injured young athletes, infant foot conditions, simple and complex gait disorders, chronic pain or disability.

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