Flatfoot is a common deformity in both children and adults. When it occurs in children, it's called pediatric flatfoot. Although there are different types of flatfoot, they all have one thing in common – partial or total collapse of the arch. Pediatric flatfoot can be classified as symptomatic (showing symptoms, i.e. pain and discomfort) or asymptomatic (showing no symptoms).

Symptoms
Children can either be born with flatfoot or they may develop it years later. Most children with this deformity show no symptoms, but some show one or more of the following symptoms:

- Pain, sensitivity/tenderness, or cramping in the foot, leg, and knee
- Outward tilting of the heel
- Changes in walking
- Difficulty with shoes
- Reduced energy when engaging in physical activities
- A tendency to avoid physical activities altogether

Diagnosis
To diagnose flatfoot, the doctor examines the foot and observes when the child stands, walks, and sits - evaluating range of motion and overall behavior. Because flatfoot can sometimes be a result of problems in the leg, the doctor may also look at the knee and hip. X-rays are often necessary in diagnosing the severity.

Non-surgical Treatment
Often treatment is not required if a child is showing no symptoms. Instead, your doctor will continue to periodically monitor and evaluate the condition. In some cases, custom orthotics may be considered even for children with no obvious symptoms.
Your doctor may select one or more of the following non-surgical treatments:

- Temporarily modify/ decrease activities that cause pain as well as avoid walking or standing for long periods of time.
- Custom orthotic devices to support the structure of the foot.
- Stretching exercises, when supervised by a medical professional, can provide relief in some cases.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to help reduce inflammation/pain.
- Your doctor will advise you on footwear specifications to adhere to when selecting shoes for the child.

Is Surgery Necessary?
Depending on the severity of the deformity, surgery may be necessary. Your doctor will choose the best surgical treatment that will ultimately relieve the pain and improve overall foot function.