What is Pediatric Flatfoot?
Flatfoot is a common disorder in both children and adults. "Pediatric flatfoot" is a deformity which occurs in children. Although there are differences between the various forms of flatfoot, overall all flatfoot types share one characteristic, which is the partial or total collapse of the arch. Most children with flatfoot have little to no symptoms, but few children have one or more symptoms.
What are the symptoms of Pediatric Flatfoot?
When symptoms occur, they vary according to the type of flatfoot. Some signs and symptoms may include:
- Pain, tenderness, or cramping in the foot, leg, and knee
- Outward tilting of the heel
- Awkwardness or changes in walking
- Difficulty walking while wearing shoes
- Loss of energy when participating in physical activities
- Voluntary withdrawal from physical activities.
Flatfoot can be apparent at birth or it may be many years later before the deformity shows. Some forms of flatfoot occur in one foot only, while others may affect both feet.
What are different types of Pediatric Flatfoot?
Various terms are used to describe the different types of flatfoot. For example, flatfoot is either asymptomatic (without symptoms) or symptomatic (with symptoms). As mentioned earlier, the majority of children with flatfoot have an asymptomatic condition. Symptomatic flatfoot is further described as being either flexible or rigid. A flexible symptom may mean that the foot is flat when standing or weight is put on the foot, but the arch returns when not standing. A rigid symptom means that the arch is always stiff and flat, whether standing on the foot or sitting. Several types of flatfoot are categorized as rigid. The most common are:
- Tarsal coalition. This is a condition that exists at birth. It involves an abnormal joining of two or more bones in the foot. Tarsal coalition could cause pain. When pain does occur, it usually starts in preadolescence or adolescence.
- Congenital vertical talus. This condition is apparent in newborns. Symptoms begin at walking age, since this is the stage that the signs show the child's difficulty while bearing weight and wearing shoes. There are other types of pediatric flatfoot could possibly be caused by injury or some diseases.
How is Pediatric Flatfoot diagnosed?
In diagnosing flatfoot, the podiatrist examines the patient's foot and observes how it looks when the child stands and sits. Your podiatrist also observes how the child walks and evaluates the range of motion of the foot. Because flatfoot is sometimes associated with problems in the leg, your podiatrist may also examine the knees and hips. X-rays are often taken to determine the severity of the deformity. Sometimes, but rarely an MRI study, CT scan, and blood tests are ordered.
What are the non-surgical treatments for Pediatric Flatfoot?
If a child's flatfoot is asymptomatic, treatment is often not required. Instead, the condition will be observed periodically by your podiatrist. In symptomatic pediatric flatfoot, treatment is required. Your podiatrist may select one or more approaches, depending on the child's particular case. Some examples of non-surgical options include:
- The child needs to temporarily decrease activities that bring pain as well as avoid prolonged walking or standing.
- Your podiatrist can provide custom orthotic devices that fit inside shoes to support the structure of the foot and improve activity functions.
- At home stretching exercises, or physical therapy may provide relief in some cases of flatfoot. To perform at-home exercises, watch our video of Basic Stretching Exercises or you can view the handout of stretching exercises.
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to help reduce pain and inflammation.
- Your podiatrist will advise you on important footwear characteristics for the child with flatfoot.
When Is Surgery Needed?
In some cases, surgery is necessary to relieve the symptoms and improve foot function. Your podiatrist will select a surgical procedure or combination of procedures best fit for your child depending on his or her particular type of flatfoot and degree of deformity.