Not every child with flat feet needs orthoses. We consider pain, fatigue, falls, gait, footwear and development for the child's age.
Some loading patterns are part of normal development; others deserve assessment because of pain, fatigue, falls, shoe wear or difficulty with activity. Decisions should not be based simply on the shape of the foot.
At MEDIPIE we assess age, gait, mobility, symptoms, footwear, activity and development. If an orthosis is indicated, it is prescribed for a specific objective and reviewed over time.
When indicated, an orthosis may help improve tolerance, provide support or accompany a functional adaptation. It is not used for appearance or because of a footprint alone.
In many cases explanation, observation, suitable footwear or periodic review may be enough. Families should receive clear, non-alarmist information.
The approach depends on symptoms, flexibility, symmetry and development, not on a single image of the arch.
A flexible, pain-free, symmetrical foot that is compatible with usual activity may need explanation and monitoring only.
Recurring fatigue, problematic shoe wear, frequent falls or progressive change justify relating gait to development.
Persistent pain, stiffness, marked asymmetry, loss of function or neuromuscular signs require caution and, when appropriate, coordination with other professionals.
No. Children's feet change with growth and many flexible flat feet do not cause problems. The decision depends on pain, fatigue, mobility, gait, asymmetry, footwear, activity and development; arch shape alone is not a reason to treat.
Assessment is useful when there is pain, limiting fatigue, repeated falls, stiffness, marked asymmetry, progressive change, footwear difficulty or concern about gait. It is also appropriate when another professional recommends reviewing foot support or there is a neuromuscular history.
Note changes in pain, fatigue, stiffness, asymmetry or participation before the visit.
Age, pain, fatigue, falls and development help guide assessment. Bring usual footwear and previous reports if available.
Clinical content reviewed by Juan Bautista Calero Márquez, podiatrist registered no. 115 in the Region of Murcia.
The Cochrane review on foot orthoses for children's flat feet found low or very low certainty evidence and did not support routine custom orthoses for healthy children with asymptomatic flexible flat feet.
We therefore give more weight to pain, functional limitation, stiffness, fatigue, gait, development and the specific diagnosis than to arch shape in isolation.
Clinical source: Cochrane · Foot orthoses for treating flat feet in children