Most of the times, a flat foot in children up to 7-8 years of age is an index of normality.

In fact, the growth of a child which leads him from “crawling” to standing and a bipodalic walking, is marked by a lot of falls.

As a consequence, during this moment, the child has the advantage of owning a wide support base. This gives him some stability to these initially uncertain attempts, which become more and more reliable and bold.

If we observe the track left in the sand by a child, or a wet small foot on a regular surface, we immediately have a visual image of the flat foot: a wide support surface.

When the walking motor pattern is completely assimilated, then the running one, jumps, and sports activity must be learnt.

Obviously, as time goes by, from 8 to 13-14 years of age, the foot will gradually normalise itself among almost all the pediatric population.

It is a path that has been acquired throughout the centuries of our evolution, written in our genes.

It is not possible to think that we are able to “correct” the message which history wanted to deposit into our DNAs with some supports, orthopedic insoles or specific exercises.

The Doctor’s role, Specialist in Orthopedics, is simply to observe and notice in the child’s growth the normality traits of this evolution, and to recognise those unusual cases of pathology in an adult’s foot, that is cases of alteration of the physiological evolution of a pediatric flat foot.

Flat foot in children

Walking on tiptoe with feet turned inward, and an attitude which leads to frequent falls while running can take part, most of the times, in this physiological path. Nevertheless, of course, the specialist’s evaluation is suggested.

In the past, they used to identify foot flatness with a “trainable” weakness of some muscle groups.

For this reason, some specific exercises used to be recommended in order to “strengthen” or “facilitate” the use of these muscles. This is why some sports are preferred to others with therapeutic purposes.

How many children are urged to give up their favourite sport, for instance, because they have to choose another one? How many of them will truly apply themselves? And how many of them, instead, will “bend” themselves to the therapeutic decision by abandoning every kind of sports activity shortly afterwards?

The role of sports in a pediatric flat foot

So, be careful to not to convert sports into a corrective exercise and a duty. A sport needs to be experienced as a game which allows to assimilate different motor patterns: the more different sports are done, the more complete the motor and proprioceptive growth of your child will be.

When, instead, the foot growth moves aways from physiology, it is good to become aware of it in time, in order not to lose some therapeutic opportunities which are linked to the residual growth of the child.

But unfortunately, an orthopedic insole does not achieve this aim.

piede-piatto-bambino-sport

Pediatric flat foot: when to intervene?

Sure enough, current scientific facts have excluded every corrective possibility from orthotics and insoles. This does not mean that they are contraindicated a priori, but that they need to be used exclusively for painful symptomatology control, in order to facilitate an harmonic support.

The first feature of an orthopedic insole is therefore comfort!

The second one has to be the awareness of the fact that the ones who suggest them will not be the creators of the correction when this one turns out to be necessary.

The role of the Doctor-Orthopedic Surgeon, a silent observer of the development of a physiological flat foot becomes, in terms of pathology, the role of a careful promoter of a mini-invasive surgical correction.