Flat feet are normal in babies and young children: the arch develops gradually through childhood, and most flat feet are flexible, painless and need no treatment. A flexible flat foot shows an arch when the child stands on tiptoe or sits with the feet hanging. Flat feet are worth having checked if they are painful, stiff, affect only one foot or are getting in the way of activity.
Also known as paediatric flat foot, pes planus, fallen arches in children, flexible flat foot
Anatomy: where the problem is
Outer side view of the ankle and foot. Highlighted in the diagram: arch of the foot.
Symptoms
- A low or absent arch when standing
- An arch that appears when the child stands on tiptoe (a flexible flat foot)
- Heels that tilt outwards when viewed from behind
- Usually no pain at all
- Sometimes aching or tired feet and legs after activity
- Uneven shoe wear
Causes and risk factors
- Normal development: arches form gradually during childhood
- Naturally flexible joints
- A family tendency to flat feet
- Being overweight, which is linked to flatter feet in children
- Tight calf muscles
- Rarely, a stiff flat foot caused by bones in the foot that are joined together, or a neurological or muscle condition
What the evidence says helps
- Flat feet in young children are part of normal development. A review of studies confirmed that children's feet become less flat with age, although there is no agreed age at which the arch is fully formed.2
- Most flat feet do not need treatment. In the study of 3 to 6 year olds, more than 90 per cent of the treatments children had been given were judged unnecessary.1
- A Cochrane review found that for children with flat feet and no pain, insoles probably make little or no difference to pain or function.3
- For children whose flat feet are painful, the evidence on insoles is uncertain. Simple, off-the-shelf insoles may be tried, and custom orthoses have not been shown to be clearly better.3
- Stiff, painful or one-sided flat feet need a medical assessment to look for an underlying cause.2
Things you can try at home
- Check whether an arch appears when your child stands on tiptoe: if it does, the foot is flexible
- Let young children spend time barefoot on safe surfaces
- Choose shoes that fit well and have a firm heel and a flexible forefoot
- Encourage plenty of active play, which strengthens the feet and legs
- Do not buy arch supports for a child who has no pain
- Seek advice if your child complains of foot, ankle or leg pain, or avoids activity
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A child who cannot put weight on the leg, or has a limp with no clear cause: see a GP the same day
- A hot, red, swollen joint, or pain with a fever or feeling unwell: get same-day medical help
- Pain that wakes your child at night, or pain at rest that is not linked to activity: see your GP
- Pain with unexplained weight loss, tiredness, bruising or a lump: see your GP promptly
- A flat foot that is stiff, painful or present on one side only, or an arch that has dropped recently: see your GP or a podiatrist
How Apollo can help
We examine your child's feet, ankles and legs, watch them walk and run, and check whether the flat foot is flexible. In most cases the outcome is reassurance, with advice on footwear and activity, and we will say so plainly if no treatment is needed. Where there is pain, we may suggest exercises, simple insoles or, in selected cases, orthoses based on pressure analysis. If the foot is stiff or anything suggests an underlying condition, we refer you to your GP.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
At what age do children's arches develop?
Arches develop gradually. Most toddlers have flat feet, and the arch usually becomes visible during the primary school years. There is no exact age, and some people have low arches for life without any problem.
Does my child need insoles for flat feet?
Not if the feet are flexible and painless. Research shows insoles make little or no difference in children without symptoms. If your child has foot or leg pain, an assessment can show whether insoles are worth trying.
When should I worry about my child's flat feet?
Seek advice if the feet are painful, stiff, do not form an arch on tiptoe, affect only one side, or if your child is tripping, tiring quickly or avoiding activity.
References
- Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M (2006). Prevalence of Flat Foot in Preschool-Aged Children. Pediatrics 118:634-639. View source
- Uden H, Scharfbillig R, Causby R (2017). The typically developing paediatric foot: how flat should it be? A systematic review. Journal of Foot and Ankle Research 10. View source
- Evans AM, Rome K, Carroll M, Hawke F (2022). Foot orthoses for treating paediatric flat feet. Cochrane Database of Systematic Reviews 2022. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
