# Flat feet in children > Flat feet in children are very common and usually a normal part of growth: the arch tends to develop by itself over the first decade. Most children have no symptoms and need no treatment. See your GP or a podiatrist if there's pain, stiffness, a limp or only one foot is affected. Guide in [Children's feet](https://footanklelowerlimb.com.au/learn/topics/childrens-feet), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/developmental-flat-foot Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **Usually normal growth:** most young children have flat feet, and the arch develops by itself over the first decade. - **Flexible is the common kind:** the arch shows when the foot is off the ground or on tiptoe. - **Most children need no treatment** when the flat foot is flexible and painless. - **Pain, stiffness, a limp or one flat foot** are reasons to see your GP or a podiatrist. - **A stiff flat foot is different:** your GP or a podiatrist should check it. ## What are flat feet in children, and how common are they? Flat feet in children (developmental flat foot) means the arch along the inside of the foot is low or missing when your child stands [1]. Most are flexible: the arch shows when the foot is off the ground, such as when sitting, or when your child stands on tiptoe [1]. Flexible flat foot is usually a normal part of growth, not a disease [2]. A rigid (stiff) flat foot, where the arch doesn't come back, is rare and may have an underlying cause [2]. Children are born with flexible flat feet and build an arch over the first decade of life, so a flat foot is expected at certain ages [3]. It's very common in young children and becomes less common with age [3]. Some children never develop an arch, and for them flat feet are simply their normal shape [1]. ## What causes flat feet in children, and who gets them? Mostly it's normal growth. Children's joints and ligaments are looser than adults', their feet carry extra fatty tissue, and their muscle control is still maturing [4]. Often there's no obvious cause, and flat feet sometimes run in families [5]. Very loose joints (hypermobility) and being overweight are linked with flat feet that last [6][7]. These are links, not proven causes, and findings on weight are mixed [8]. If you're concerned about your child's weight, a health professional can help. ## What do flat feet look like, and how are they diagnosed? When your child stands, the arch disappears, the middle of the foot sags towards the ground and the heel tilts outwards [9]. Flexible flat feet usually cause no symptoms [10]. Some children do get sore or tired feet, legs or ankles (especially after activity), uneven wear on the inside of the shoe heel, or more tripping and falling [11]. A doctor can diagnose flat feet from your child's symptoms and an examination of the feet standing, sitting and walking. X-rays are sometimes ordered [10]. The key check is whether the arch comes back when the foot is off the ground [12]. > [!tip] Try this > Ask your child to sit with their feet off the floor, then to stand up on tiptoe. If an arch appears in either position, the flat foot is flexible. If it doesn't, mention it to your GP or podiatrist. ## What can I do about my child's flat feet? Most children with a flexible, painless flat foot need no treatment, just reassurance and watching how it develops [13]. No treatment is needed if the arch comes back on tiptoe or when the foot isn't bearing weight [14]. Arches usually develop somewhere between 3 and 10 years of age [5]. It isn't clear yet whether insoles, exercises or special shoes change how the arch develops. Keep an eye on how your child's feet look and feel, and see your GP or a podiatrist if anything changes. ## What helps if my child's flat foot is painful or isn't settling? If pain or limited activity continues, see your GP or a podiatrist rather than waiting. A rigid or painful flat foot in a child older than 3 years that limits activities such as running or jumping is a reason for referral to a public hospital service [15]. So are toe walking with an abnormal spine examination, asymmetry, enlarged calf muscles, or signs of cerebral palsy [15]. What comes next depends on that assessment. ## Will my child grow out of flat feet? For most children the outlook is good: the arch develops by itself during the first decade, and few children have symptoms [16]. Only a minority have a flat foot that lasts or gets worse, and pain is uncommon [7]. Being overweight and very loose joints are linked with flat feet that last [7][6]. Beyond about age ten, a flat foot can become stiffer [7]. If your child is around that age and the flat foot persists or becomes painful, see your GP or a podiatrist. ## When to see a podiatrist Most flat feet in children are harmless, and redness, swelling and warmth aren't typical of flat foot [9]. See your GP or a podiatrist the same day if: - your child's foot is red, hot or swollen [17]; - a foot looks suddenly flat after an injury, or your child can't put weight on it after an injury [17]; - your child has sudden severe pain or numbness in a leg or foot; - your child has diabetes and a wound, sore, blister or colour change on the foot. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. Go to the nearest emergency department if a joint is suddenly hot, swollen and very painful, with a fever, and your child seems unwell [15]. See your GP soon if your child's foot shape is getting worse [17], or if they develop pain when walking [10]. See your GP if your child: - has foot or leg pain that wakes them at night, which is very unusual with flat feet [9]; - has a limp with a fever; - has a limp that hasn't improved after 7 days [15]. See your GP or a podiatrist if your child has pain, stiffness, weakness or numbness in the feet, frequent injuries, walking or balance problems, or activity limited by their feet [5][1]. The same goes for flat feet that are new or affect only one foot [5][1], and for a stiff flat foot where the arch doesn't come back [2]. Older children with painful or stiff flat feet, and children whose arches were normal and later became flat, need particular attention [18]. ## Common questions ### Should my child wear special shoes for flat feet? A painless flexible flat foot doesn't need treatment, and it isn't clear yet whether special shoes change how the arch develops. Comfortable shoes that fit well are a sensible choice. If your child has foot pain or tires easily, a podiatrist can look at their feet and shoes and suggest what suits them. ### At what age do children's arches develop? Most children are born with flat feet. Arches usually develop somewhere between 3 and 10 years of age, so a flat foot in a young child is expected. Some children never develop a visible arch, and flat feet are simply their normal shape. If you're unsure how your child's feet are developing, a podiatrist can check. ### Can flat feet cause leg pain? Most flat feet cause no pain. Some children do get sore or tired feet, legs or ankles, especially during or after activity. Because other things can cause leg pain, it's worth having it looked at rather than assuming it's the flat feet. Your GP or a podiatrist can examine your child and look for the cause. ## Further reading - [Flat feet in children on Clindice](https://clindice.com/developmental-flat-foot) - [Flat foot - Paediatric Orthopaedics - Oxford University Hospitals](https://www.ouh.nhs.uk/paediatricorthopaedics/information/conditions/flat-foot/), NHS - [Flat feet](https://www.nhs.uk/conditions/flat-feet/), NHS - [Flatfoot in children](https://www.nuh.nhs.uk/flatfoot-in-children/), NHS - [Pes Planus Flat Foot](https://rms.cornwall.nhs.uk/primary_care_clinical_referral_criteria/primary_care_clinical_referral_criteria/orthopaedics/primary_care_clinical_referral_criteria/primary_care_clinical_referral_criteria/orthopaedics/foot_and_ankle_referral/pes_planus_flat_foot), NHS - [Display Patient Information Leaflets](https://www.plymouthhospitals.nhs.uk/display-pil/pil-flat-feet-in-children-5925/), NHS ## Sources 1. Flat Feet in Children - Information for Parents · United Lincolnshire Hospitals. https://www.ulh.nhs.uk/patients/patient-information-library/flat-feet-in-children-information-for-parents/ 2. Risk Factors of Flatfoot in Children: A Systematic Review and Meta-Analysis · Xu L, Gu H, Zhang Y et al. · International Journal of Environmental Research and Public Health · 2022. https://doi.org/10.3390/ijerph19148247 3. The typically developing paediatric foot: how flat should it be? A systematic review · Uden H, Scharfbillig R, Causby R · Journal of Foot and Ankle Research · 2017. https://doi.org/10.1186/s13047-017-0218-1 4. Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review · Banwell HA, Paris ME, Mackintosh S et al. · Journal of Foot and Ankle Research · 2018. https://doi.org/10.1186/s13047-018-0264-3 5. Flat feet · NHS · 2018. https://www.nhs.uk/conditions/flat-feet/ 6. A Cochrane review of the evidence for non-surgical interventions for flexible pediatric flat feet · Evans AM, Rome K · European Journal of Physical and Rehabilitation Medicine · 2011. https://pubmed.ncbi.nlm.nih.gov/21448121/ 7. S2-Guideline: Pediatric Flat Foot · Hell AK, Döderlein L, Eberhardt O et al. · Zeitschrift Fur Orthopadie und Unfallchirurgie · 2018. https://doi.org/10.1055/s-0044-101066 8. Understanding foot conditions, morphologies and functions in children: a current review · Jiang H, Mei Q, Wang Y et al. · Frontiers in Bioengineering and Biotechnology · 2023. https://doi.org/10.3389/fbioe.2023.1192524 9. Flexible flatfoot in children and adolescents · Mosca VS · Journal of Children's Orthopaedics · 2010. https://doi.org/10.1007/s11832-010-0239-9 10. Flat feet factsheet · The Sydney Children's Hospitals Network. https://www.schn.health.nsw.gov.au/factsheets/flat-feet 11. Flat feet (fallen arches) · Healthdirect Australia. https://www.healthdirect.gov.au/conditions/joint-and-muscle-diseases/flat-feet 12. Risk factors that may adversely modify the natural history of the pediatric pronated foot · Napolitano C, Walsh S, Mahoney L et al. · Clinics in Podiatric Medicine and Surgery · 2000. https://pubmed.ncbi.nlm.nih.gov/10943496/ 13. Pediatric flatfoot: cause, epidemiology, assessment, and treatment · Dare DM, Dodwell ER · Current Opinion in Pediatrics · 2014. https://doi.org/10.1097/mop.0000000000000039 14. Flat Feet - Paediatric CPC · SA Health. https://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/Services/Outpatients/CPC/specialities/Orthopaedics/Flat+Feet+Paediatric+CPC 15. Assessment of non-traumatic foot and ankle conditions in children · Victorian Government. https://www.health.vic.gov.au/statewide-referral-criteria/assessment-of-non-traumatic-foot-and-ankle-conditions-in-children 16. Flexible Flatfoot-Epidemiology, Pathophysiology and Clinical Aspects: A Review Focused on Less-Invasive Surgical Treatment in Children · De Maio F, Micciulli E, Lardo D et al. · Children (Basel, Switzerland) · 2026. https://doi.org/10.3390/children13070881 17. Pes Planus Flat Foot · NHS. https://rms.cornwall.nhs.uk/primary_care_clinical_referral_criteria/primary_care_clinical_referral_criteria/orthopaedics/primary_care_clinical_referral_criteria/primary_care_clinical_referral_criteria/orthopaedics/foot_and_ankle_referral/pes_planus_flat_foot 18. Flat foot - Paediatric Orthopaedics · NHS. https://www.ouh.nhs.uk/paediatricorthopaedics/information/conditions/flat-foot/ --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.