Clinically reviewed by What is flat feet in children
Nearly every baby is born with flat feet. The arch is filled with soft fat, the ligaments are loose, and the foot looks completely flat when the child stands. Parents here call it chapta pair.
The arch develops on its own as the child walks and the muscles strengthen. In most children it is visible by around six years of age, and in some later. A flat foot in a three year old is normal.
The useful test is simple. Ask your child to stand on tiptoes. If an arch appears, the foot is flexible, and a flexible, painless flat foot needs no treatment at all.
Symptoms you might have
- Normal: flat soles in a child under six, with an arch appearing on tiptoes
- Normal: feet that roll inwards a little, with normal running and playing
- Normal: shoes wearing down on the inner edge
- Worth checking: pain in the foot, heel or leg after short walks
- Worth checking: a foot that stays flat on tiptoes, so it is stiff rather than flexible
- Worth checking: one foot flat and the other not
- Worth checking: a child who limps, or stops wanting to play
- Worth checking: no arch by around eight, or a foot getting flatter
Why it happens
- Normal development, which accounts for the large majority of flat feet in young children
- Naturally flexible ligaments, which often run in families and are not a disease
- A tight calf, which pulls the heel up and lets the arch collapse inwards
- Extra body weight, which flattens the arch further while standing
- Bones in the back of the foot joined together, giving a stiff, painful foot in older children
- Low muscle tone, where the child is floppier and may have been slow to walk
- Cerebral palsy and other conditions affecting muscle tone
When you should see a physiotherapist
Most children do not need an appointment for flat feet. If the feet are flexible and painless and your child runs and plays normally, you can leave them alone with confidence.
Bring your child in if the feet hurt, if walking distance is limited, if only one foot is flat, if the foot stays flat on tiptoes, or if there is no arch by around eight. A stiff, painful flat foot needs an orthopaedic opinion, and so does a foot becoming flatter over months.
Go to a doctor urgently if your child loses a skill he already had, such as walking, if the muscles suddenly become stiff or floppy, or if there is pain at night or pain with fever. Delayed walking and cerebral palsy have their own pages.
Al-Shama Physiotherapy Clinic
Ask about an appointment
اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
Fill this in and WhatsApp will open with your details ready to send.
یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
The first thing treatment does is sort the normal feet from the few that need help. For a flexible, painless flat foot the honest answer is that nothing needs doing, and we will tell you that.
- Assessment of whether the foot is flexible or stiff, whether the calf is tight, and how your child walks
- Calf stretching, the most useful single exercise when the heel cord is tight
- Foot and ankle strengthening through play: heel raises, walking on tiptoes, picking things up with the toes
- Barefoot play on grass, sand and uneven ground, which builds the arch muscles better than any shoe
- Footwear advice: a flexible shoe with a firm heel, not a stiff boot
- Insoles only where there is genuine pain, for a limited period alongside the exercises
Insoles do not build an arch and the evidence does not support them for painless flat feet, so we do not sell them to parents of healthy feet. Surgery is rare and only for stiff, painful feet. Electrotherapy, ultrasound, TENS, dry needling and cupping are not used on young children.
Exercises, and what to avoid
What helps
- Walking on tiptoes across the room, then on the heels, turned into a game
- Heel raises holding a wall, ten to fifteen at a time, once your child can copy you
- Calf stretching with the heel down, held twenty to thirty seconds, if the calf is tight
- Barefoot running on grass and sand, and picking up marbles with the toes
What to avoid
- Buying arch support insoles for a painless flat foot
- Stiff, heavy boots, which stop the foot muscles working
- Thin flat chappals for long walks on hard ground, if the feet ache
- Making your child self conscious. A painless flat foot is not a defect
What you can do at home
Let your child go barefoot indoors and on safe soft ground outdoors. This is the cheapest and most effective thing you can do for a developing foot.
Choose shoes that bend at the ball of the foot, with a firm heel cup and room for the toes. Expensive corrective shoes are not needed.
Encourage running, climbing and jumping. Active children develop stronger feet.
If the feet ache after a long day, rest and a cool foot soak are enough. Heat packs, electrical machines and cupping are not used on children.
If your child is carrying extra weight, that matters more for foot pain than the shape of the arch.
How long it takes
The arch develops gradually over years. Most children show a visible arch by around six, and some not until eight or later. Nothing needs to be done while you wait.
Where there is foot pain and a tight calf, stretching and strengthening usually settle the pain within six to twelve weeks.
A stiff flat foot does not change with exercise and needs a specialist opinion, so there is no timeline to promise there.
What makes a difference is activity, barefoot play, sensible shoes and body weight. What makes no difference at all is insoles in a painless foot, no matter how long they are worn.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
چپٹے پیر چھوٹے بچوں میں بالکل نارمل ہیں۔ پیدا ہونے پر ہر بچے کا تلوا چپٹا ہوتا ہے، اور آرچ دھیرے دھیرے بنتا ہے، زیادہ تر بچوں میں چھ سال تک۔
آسان ٹیسٹ: بچے کو پنجوں پر کھڑا کریں۔ اگر آرچ بن جائے تو پیر لچکدار ہے، اور لچکدار اور درد سے خالی چپٹے پیر کو کسی علاج کی ضرورت نہیں۔
دیکھنے والی باتیں: پیر میں درد، ایک پیر چپٹا اور دوسرا ٹھیک، پنجوں پر بھی پیر چپٹا رہنا، یا آٹھ سال تک آرچ نہ بننا۔
بہترین علاج مفت ہے: گھاس پر ننگے پیر کھیلنا، پنجوں پر چلنا، اور پنڈلی کی اسٹریچنگ۔ اگر بچہ کوئی سیکھا ہوا کام بھول جائے، جیسے چلنا، تو فوراً ڈاکٹر کو دکھائیں۔
Roman Urdu
Chapte pair chote bachon mein bilkul normal hain. Paida hone par har bache ka talwa chapta hota hai, aur arch dheere dheere banta hai, zyada tar bachon mein chhe saal tak.
Asan test: bache ko panjon par khara karen. Agar arch ban jaye to pair lachakdar hai, aur lachakdar aur dard se khali chapte pair ko kisi ilaj ki zaroorat nahi.
Dekhne wali baatein: pair mein dard, ek pair chapta aur doosra theek, panjon par bhi pair chapta rehna, ya aath saal tak arch na banna.
Behtareen ilaj mufat hai: ghaas par nange pair khelna, panjon par chalna, aur calf ki stretching. Agar bacha koi seekha hua kaam bhool jaye, jaise chalna, to foran doctor ko dikhayen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
At what age should my child's arch appear?
Does my child need arch support insoles?
My child's legs hurt at night, is it the flat feet?
Can exercises correct flat feet?
Should my child wear shoes or go barefoot?
Related conditions
- Cerebral palsy treatment and physiotherapy
- Torticollis in babies
- Child not walking
- Delayed developmental milestones
- Low muscle tone in babies