Flat-foot treatment often not needed, study finds

Flat feet in young children improve on their own in the great majority of cases, meaning that treatment with arch supports or special shoes may often be unnecessary, according to a new study.

“Children with typical flexible flat foot should not be burdened with arch supports or corrective shoes,” Dr. Martin Pfeiffer of the Medical University of Vienna and colleagues conclude in the journal Pediatrics.

Babies are born with flat feet, with arches gradually developing in the first years of life, Pfeiffer and his team note. While many parents will seek treatment for a young child’s flat feet, they add, researchers increasingly believe that such treatment is not necessary in most cases.

Treatment is required for rigid flat foot, which can cause pain and disability, Pfeiffer and his colleagues say. But flexible flat foot—in which the arch may disappear while the child is standing but reappears when the big toe is stretched out or a child stands on tiptoes—is increasingly thought of as a normal stage of development.

To investigate the frequency of flat foot among young children and determine how often it may be treated unnecessarily, the researchers looked at a group of 835 children aged 3 to 6.

Seven children, or less than 1%, had rigid flat foot, while 44% had flexible flat foot, the researchers found. Flat foot became less common with age, with 54% of 3-year-olds having flat feet compared to 24% of 6-year-olds. Boys were more than twice as likely as girls to have flat feet. Underweight children were nearly twice as likely as normal-weight children to have flat feet, while obesity tripled the risk of flat-footedness.

While 10% of the children were receiving flat foot treatment with arch supports, this treatment was unnecessary in most cases, the researchers write.

Arch supports and special shoes are uncomfortable for children, Pfeiffer and his colleagues note. There is also evidence, they add, that using arch supports—or even wearing shoes regularly before age 6—may worsen flat foot by interfering with the normal development of foot muscles.

They conclude: “Treatment of children with physiological flat foot is ineffective and produces enormous costs for parents and health service providers.”

SOURCE: Pediatrics, August 2006.

Print Version
Tell-a-Friend