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Our son was flat footed with very little arch. His pediatrician was not concerned.

In preschool, he complained of discomfort when wearing shoes with an arch support. By age 9-10, his condition resulted in continual knee and hip pain. Our doctor explained to us it was just "growing pains" from rapid growth spurts. He was never concerned about his feet.

Finally, a physical therapist that I worked with educated us in exercises, wrapping support and identification of supportive shoes. This information and strategies stopped his pain.

As a parent, it is frustrating to know that information was available that would have prevented pain and discomfort in your child, yet you did not know of it. One of the roles of parents is to continuously gather information that may or may not be needed for your child.

What should parents know about "flat feet"?

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3 Answers

Babies are born with flatfeet. Per the Univeristy of Maryland Medical Center, eighty percent of children will develop an arch between the ages of 3 and 10 years. The remaining 20 percent will likely have flatfeet. One or both feet may be affected.

A foot is flat if the arch of the foot touches or nearly touches the floor when the child stands. A wet footprint can quickly identify the absence or presence of an arch. A wide connection between the forefoot and heal on the print indicates a flatfoot or a limited arch.

There are two types of flatfeet; rigid and flexible. Rigid flatfeet are due to fusing of bones or abnormal development in the feet and has more serious consequences than flexible flatfeet. A physician will likely identify and treat rigid flatfeet with orthotics or surgery after an extensive medical work up. However, physicians are rarely concerned about flexible flatfeet and the vast majority of children will require no treatment for the condition.

Most children with flexible flatfeet are asymptomatic. However, some children complain of discomfort when wearing footwear with arch supports. Other children are clumsy or walk oddly to compensate for pain and discomfort. Very active children or ones who participate in sports requiring running or jumping sometimes complain of foot and leg pain or limp and fatigue on long walks. Sometimes, the ankles roll inward as a child walks or runs and creates uneven wear patterns on shoes and causes stress and associated pain in knees and hips.

Arch Supports: Parents should be aware of the degree of arch in their child's feet and buy shoes that match the arch to provide for comfort and support. Shoes with arch supports of easily molded material with good shock absorbing capacity are recommended. Shoes with high arch support do not help a child develop arches and may even contribute to weaker arches and flatter feet.

Orthotics: There is no evidence that wearing orthotics are effective treatments to correct flatfeet. However, orthotics may be useful in preventing the ankles from rolling inward and reduce the strain on muscles and the associated pain.

Our son found that wearing over the counter 3/4 length inserts significantly reduced his knee and leg pain.

Wrapping: Properly wrapping ankles with elastic bandages to support them during sports activities may be beneficial.

This significantly reduced our son's pain during running activities such as Pee Wee basketball and track.

Barefoot: Going barefoot is the best protection against flatfeet per research. Arches can be strengthened by going barefoot on uneven terrain. Walking in sand is especially exercising.

Shoes: Wearing sandals or slippers may help support development of arches. Shoes should be lightweight and flexible with the sole generally rectangular shaped.

We found that it required some searching to find shoes that the toe and heel were generally the same width with no cut out or narrowing of shape at the arch. The most popular and most expensive shoes usually did not meet the criteria.

Exercise: Foot gymnastics are games and exercises that may contribute to improve arch development in children. Our son actually enjoyed these activities.

Weight: Obesity also contributes to flatfeet and is just one more reason for maintaining more optimum weight.

I am happy to report that our son is now an adult and no longer has flat feet or the associated pain and discomfort he suffered as a child. I am thankful that we discovered the information we needed to support that outcome.

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I have exceedingly flat feet. For as long as I can remember until about 16 I had all my shoes built up with orthotics - which for a teenager being limited to "real" shoes rather than sneakers was a pain.

I also had regular physiotherapy appointments and was meant to carry that through in my day to day life.

I then tried to take care with the footwear I was buying and make sure that it always had good support.

This was all supposed to reduce the chance of problems in later life.

About 5 years ago (age 30) I started to have knee problems and this was identified as being related once again to my flat feet. New orthotics and exercise were proscribed and not much helped.

Recently I have taken a different tack. I have started to wear "barefoot" trainers, with minimal sole and built-in support. There are several on the market, the most prominent being Vibram 5 fingers, and these seem to be helping.

I would like to back this up with exercise to build up the strength of my knees now they are feeling better - I should be doing exercise bike 30 mins a day, but with a 1 year old have neither time nor money.

I should also be doing tendon stretches on my Achilles - standing on a step and dropping my heels.

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Parents worry about flatfeet, but. flatfeet are normal in infants, children and adults. Special shoes, inserts, wedges, or exercises do not create an arch in a child with a flexible flatfoot Flatfeet.

Did You Know? One in five children never develops an arch. Most adults with flexible flatfeet have strong, pain free feet

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