Q. My daughter has flat feet. Her pediatrician does not seem concerned about it, but I still am. What should I do?
A. Pes planus, or flat feet, is a condition where the entire foot, including the instep, makes contact with the ground when standing. To understand flat feet, it is important to understand how the arch develops.
Typically, arches in the feet develop by age 3 but may develop as late as age 5. Arch development occurs as loose tendons in the feet tighten during the first few years of life. For this reason, pes planus in young children is considered normal.
Older children and adults with flat feet are divided into to subsets: rigid versus flexible flat feet. When a person with flexible flat feet elevates onto her tip-toes, an arch forms. This arch disappears when standing flat. For a person with rigid flat feet, the instep remains flat at all times.
Rigid flat feet may be caused by a condition called tarsal coalition and should be evaluated by an orthopaedic surgeon. Flexible flat feet generally require no treatment unless the person is experiencing pain.
Heel cord stretching exercises and wearing shoes with good arch supports can help alleviate pain.