Flat little tootsies.....what should we do about them?

Toddler feet. Dang they’re cute.

So pudgy.

But they sure can cause a fair bit of worry amongst Mummas and Pappas.

An occupational therapist friend recently threw me a question about what the latest is with ‘flat feet’ in toddlers..….and so here goes my next #titbittuesday peeps….on #flatfeet.

So, your darling little baby is all growsed up and is starting to toddle around on those chubby little tootsies. And they’re looking a little pancakey. Cue worried parents. But is there really anything to worry about?

One of the most important take-away messages from today is to recognise the majority of toddlers with flexible ‘flat feet’ will spontaneously resolve between the ages of 3 and 6. Every single bubba on earth has flat feet to start. The arch of the foot doesn’t start to develop until after the age of 2. So for the majority of cases all you need to do is wait and watch.

You don’t need special orthopaedic shoes. Just lots of time in bare feet walking on different surfaces, and in good-fitting shoes when they’re out and about (there’s a whole fact sheet on what to look for in footwear in my ebook).

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So is it necessary to do anything about flat feet at all? If you are solely going by what ‘the evidence’ says, no intervention has been found to ‘significantly alter the natural course of foot shape development’ in a child with flat feet. Meaning if your older child has ‘flexible flat feet’ they will probably always have flat feet to a degree. And that’s ok, just like in adults, there is a whole range of normal. It’s what makes the world go round right?

Painful flexible flat-feet in an older child is different however, and requires assessment by a physiotherapist and perhaps a podiatrist. Treatment options for symptomatic kiddos include physio, shoe wear modification, orthotics, and very occasionally, surgery.

So that brings me to my second main point.

If you are really very concerned about your toddler’s flat feet, especially if their gross motor development is delayed compared to other children their age, it can’t hurt to get them looked at. If you can address something early and hopefully avoid ‘painful flat feet’ later on in childhood, then why wouldn’t you?

It may be as simple as getting some general strengthening exercises that will help to support normal development. As I always say, you should never be embarrassed to seek help. It’s what we’re here for.

A trained paediatric therapist will be able to assess for any underlying issues such as joint hyper-mobility, or an issue with the structures in the foot, and go over what your treatment options are. They will also be able to refer on to other health services if needed.

As a very general rule, I often give out ‘foot awareness’ exercises for kids with mild tootsie issues.

In bare feet, try the following:

  • Tip toe and heel walking

  • Walking on different surfaces: (sand and grass, soft foam mats etc)

  • Jumping or even just walking on a trampoline

  • Wobble boards

  • Trikes and scooters (take care with bare feet here though, nothing too fast!)

  • Pushing against an adult sized fit ball with their feet

  • Animal walks (such as bear walking on hands and feet)

  • Walking up a slide

And for those that are into it, this is a great article summarising the available evidence on flat feet.

https://pediatrics.aappublications.org/content/137/3/e20151230

Alana xxx

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