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Anurag
Anurag
Published Date28 Sept'26
Last Updated28 Sept'26
Read Time17 Minutes
About
Flat feet are common in children, and in many cases they are a normal part of foot development rather than a problem that needs correction. A child's arch can appear low or absent when standing and become more visible when the child sits, rises onto their toes or does not put weight on the foot.
The important question for parents is therefore not simply, "Does my child have flat feet?"
It is:
"Are my child's flat feet causing symptoms or affecting normal activity, and does my child actually need arch support?"
For many children with painless, flexible flat feet, treatment is not necessary. Current pediatric guidance recommends observation and reassurance for asymptomatic flexible flatfoot, particularly in younger children. Routine use of arch supports or corrective footwear has not been shown to change normal arch development.
Arch supports may have a role when flat feet are associated with pain, fatigue, functional limitations or other symptoms. In those situations, an orthotic may be considered for symptom relief rather than as a guaranteed way to permanently "build" the arch.
This guide explains how flat feet develop in children, when they are usually considered normal, when arch support may be useful, what parents should look for and when a child should be assessed by a healthcare professional.
Not always.
Most children with asymptomatic flexible flat feet do not automatically need arch supports.
A 2026 systematic-review-based consensus recommends observation for asymptomatic flexible flatfoot and states that routine orthoses or corrective footwear are not supported for the purpose of changing normal arch development.
Arch support becomes more relevant when a child has symptoms such as:
Foot pain
Ankle discomfort
Frequent foot fatigue
Difficulty with prolonged walking or standing
Activity-related discomfort
Functional limitations
Symptoms that interfere with sports or daily activities
In these situations, a healthcare professional may consider whether an orthosis or other intervention could provide symptom relief.
The simple rule for parents
Flat feet + no symptoms = usually observation.
Flat feet + persistent pain or functional problems = assessment and potentially supportive treatment.
This distinction is more useful than deciding whether a child needs arch support based solely on how flat the foot looks.
Yes. Flat feet can be a normal developmental finding in children.
Young children naturally have less pronounced arches than adults. The medial longitudinal arch develops progressively during childhood.
The 2026 pediatric flatfoot consensus notes that spontaneous arch development occurs during the first decade of life and that most children develop a normal-looking arch by around age 10 without intervention.
That means parents should not assume that a visible flat foot automatically means something is wrong.
The appearance of a child's foot should be considered alongside:
Age
Whether the foot is flexible
Presence or absence of pain
Walking ability
Activity level
Symmetry between the feet
Any associated medical conditions
Flexible flatfoot is a type of flatfoot in which the arch appears when the foot is not bearing weight but flattens when the child stands.
For example, a child's arch may:
Appear while sitting
Become visible when standing on tiptoes
Flatten when standing normally
This flexibility is an important distinction because it differs from a rigid flatfoot, where the arch remains flattened and the foot does not move normally.
Flexible flatfoot is common in children and is often asymptomatic. Research also shows that there is no universally accepted single measurement for diagnosing pediatric flexible flatfoot, which is why clinical assessment is more useful than relying on a simple home test alone.
| Flexible Flat Feet | Rigid Flat Feet |
|---|---|
| Arch may appear when the child is not standing | Arch remains flattened |
| Foot remains relatively mobile | Foot may have restricted movement |
| Often painless | More likely to require investigation when symptomatic |
| Common in childhood | Less typical and may have an underlying structural cause |
| Often observed without treatment | May require professional assessment |
A rigid or painful flatfoot deserves more attention than a painless flexible flatfoot.
A parent should not attempt to diagnose the difference independently, but noticing that a child's foot is unusually stiff, painful or asymmetric is a reason to seek professional advice.
There is no single age at which every child's arch suddenly appears.
Arch development occurs progressively during childhood.
According to the 2026 pediatric flatfoot consensus, most spontaneous arch development occurs during the first decade of life, with most children achieving a normal arch by around age 10. The guideline recommends structured reassessment around ages 8–10 for children with persistent flexible flatfoot, particularly when there are concerns.
This does not mean that every child without a visible arch at age 10 has a problem.
Age should be considered together with symptoms, flexibility and function.
Flat feet are more concerning when they are painful, rigid, progressively changing or affecting a child's normal activities.
Parents should pay attention to:
1. Persistent Foot Pain
Pain is one of the most important reasons to seek an evaluation.
Look for complaints such as:
Pain in the arch
Heel discomfort
Pain around the ankle
Pain after walking
Pain during sports
Pain that repeatedly returns after activity
2. Frequent Foot Fatigue
A child who repeatedly complains that their feet or legs feel tired after relatively normal activity may benefit from an assessment.
Fatigue by itself does not prove that flat feet are the cause, but it is useful information.
3. Difficulty Walking or Running
Pay attention if your child:
Avoids walking
Stops participating in sports
Tires unusually quickly
Complains after short periods of activity
Changes the way they walk or run
4. A Stiff or Rigid Foot
A foot that appears flat and does not regain an arch during non-weight-bearing or tiptoe positions may warrant assessment.
5. One Foot Looks Different
A significant difference between the two feet is worth discussing with a healthcare professional, particularly if it is associated with pain or functional changes.
Parents should consider professional assessment if flat feet are accompanied by:
Persistent pain
Swelling
Significant stiffness
Difficulty walking
Difficulty running
Reduced sports participation
Repeated activity-related discomfort
A noticeable difference between the feet
A progressively changing foot shape
Other developmental, neurological or musculoskeletal concerns
The appearance of a flat arch alone is generally less important than whether the child has symptoms or functional limitations.
Arch supports may help some children who have symptomatic flat feet, but they are not necessary for every child with flat feet.
Evidence regarding pediatric orthoses is mixed.
A systematic review of studies in children and adults found considerable heterogeneity and concluded that the evidence was insufficient to establish that orthoses are broadly useful for flexible flatfoot in children.
Other reviews have reported potential benefits for symptoms such as pain and function in some children, but have also highlighted limitations in study quality and differences between orthotic designs and study populations.
The practical takeaway is:
Arch supports should not be viewed as automatically necessary simply because a child has flat feet. They may be considered when there are symptoms or specific functional needs.
Arch supports should not be considered a guaranteed way to permanently correct or create a child's natural arch.
This distinction is important.
The 2026 pediatric consensus specifically recommends orthoses for symptomatic relief rather than structural arch correction and states that there is no evidence that orthoses alter the structural development of the medial longitudinal arch.
Earlier systematic research has similarly found insufficient evidence that long-term orthotic use changes the natural structural development of the pediatric arch.
Therefore, avoid claims such as:
"Arch supports permanently build your child's arch."
"Arch supports cure childhood flat feet."
"Every child with flat feet needs corrective insoles."
A more accurate statement is:
Arch supports may provide support or symptom relief for some children with symptomatic flat feet, but they are not a guaranteed method of changing normal arch development.
There is currently no strong evidence that routine arch supports are necessary to make a normal child's arch develop.
Children's arches naturally mature during growth.
The 2026 consensus recommends observation rather than routine orthotic treatment for asymptomatic flexible flatfoot and specifically states that orthoses should not be prescribed for structural arch correction.
This is particularly important for parents of young children who have no pain and are otherwise active.
If a child is comfortable, walking normally and participating in activities without difficulty, the appearance of a low arch alone generally does not mean that corrective footwear or insoles are required.
Children may be considered for arch supports when flat feet are associated with symptoms or functional problems and a healthcare professional determines that orthotic support is appropriate.
Potential situations include:
Persistent foot pain
Activity-related discomfort
Foot fatigue
Certain biomechanical problems
Specific medical conditions
Difficulty participating in normal activities
The goal should generally be symptom relief and improved function, not simply making the arch look higher.
The 2026 pediatric consensus recommends foot orthoses for symptomatic flexible flatfoot and identifies prefabricated orthoses as the default option for routine flexible flatfoot, while reserving custom devices for selected situations such as atypical foot morphology, certain conditions or failure to respond to prefabricated devices.
The answer depends on why the child needs them.
If the child has flat feet but no symptoms
Routine arch support is generally not necessary simply because the arch looks low.
Observation is typically more appropriate for asymptomatic flexible flatfoot.
If the child has flat feet and pain
An evaluation can help determine whether the flatfoot is contributing to the symptoms and whether an orthosis could help.
If the child has flat feet and difficulty with activity
The child's walking, running, strength, flexibility and foot mechanics may need to be assessed before choosing an intervention.
If the child has a rigid or unusual-looking flatfoot
A healthcare professional should evaluate the foot to determine whether there is an underlying structural cause.
There is no single "best" arch support for every child.
The appropriate support depends on:
Age
Foot size
Foot flexibility
Symptoms
Activity level
Foot shape
Underlying condition
Whether the child needs temporary symptom relief or more specialized orthotic management
For routine symptomatic flexible flatfoot, the 2026 consensus recommends prefabricated orthoses as the default and reserves custom orthoses for selected cases.
Parents should therefore avoid selecting an aggressive or highly rigid arch support simply because it has a higher arch.
More support is not automatically better support.
Not necessarily.
A child with asymptomatic flexible flat feet does not automatically need corrective shoes.
The 2026 pediatric consensus does not support routine corrective footwear for asymptomatic flexible flatfoot.
For everyday use, focus on footwear that:
Fits properly
Provides enough room for the toes
Is comfortable
Does not cause pressure points
Is appropriate for the child's activity
If a child has symptoms, footwear selection can be discussed with a healthcare professional.
Insoles may help some children with symptomatic flat feet, but they are not universally required.
Research has reported potential improvements in symptoms and function in some children using foot orthoses, but studies vary considerably in design, orthotic type, diagnostic criteria and duration.
A 2023 systematic review and meta-analysis found insufficient evidence overall to conclude that orthoses are broadly useful for flexible flatfoot in children and adults.
More recent evidence has reported improvements in some radiological and symptom outcomes, particularly in older children, but the researchers also noted the small sample sizes and need for higher-quality studies.
Therefore:
Use the child's symptoms and clinical assessment—not the appearance of the arch alone—to determine whether an insole is appropriate.
No. Orthotics are not necessary for every child with flat feet.
They are generally more relevant when a child has:
Symptoms
Functional limitations
A specific foot or lower-limb condition
Atypical foot morphology
Persistent problems that require additional support
For asymptomatic flexible flatfoot, current guidance favors observation rather than routine orthotic treatment.
If your child's healthcare professional has recommended an orthosis, consider the following:
1. Proper Fit
The support should fit the child's shoe and foot appropriately.
2. Comfort
A child should not have to tolerate significant discomfort simply because an insole is designed to provide "correction."
3. Appropriate Support
The support should match the child's needs rather than simply having the highest or hardest arch.
4. Shoe Compatibility
The insole should fit securely inside the child's footwear without crowding the toes or making the shoe excessively tight.
5. Monitoring
Watch for:
New pain
Pressure points
Blisters
Skin irritation
Changes in walking
Refusal to wear the support
If symptoms worsen after introducing an orthosis, reassessment may be appropriate.
Many children with flexible flat feet develop a more pronounced arch naturally as they grow.
The medial longitudinal arch develops during childhood, particularly throughout the first decade. Current pediatric guidance therefore recommends observation for asymptomatic flexible flatfoot rather than routine treatment aimed at accelerating arch formation.
However, "outgrow" should not be interpreted as a guarantee that every child will develop a visible adult-type arch.
Children develop at different rates, and persistent flat feet should be considered in context.
If you want to understand the broader question of arch development, see:
Can Your Foot Arch Change Over Time?
Usually, there is no reason to panic.
If your child:
Walks normally
Runs comfortably
Participates in sports
Has no persistent foot pain
Has flexible feet
Has no significant functional limitations
then the flat-foot appearance may simply be part of normal development.
Current pediatric guidance recommends observation and reassurance for asymptomatic flexible flatfoot rather than routine orthoses or corrective footwear.
Persistent pain changes the picture.
If a child has flat feet and repeatedly complains of:
Arch pain
Heel pain
Ankle pain
Foot fatigue
Pain after sports
Difficulty walking
Difficulty running
a healthcare professional can determine whether the flatfoot is contributing to the symptoms.
Orthoses may be considered for symptomatic relief in appropriate cases. Evidence suggests some symptomatic children may benefit, although results across studies are not uniform.
Flat feet can be associated with differences in foot and lower-limb mechanics, but a low arch does not automatically mean that a child's walking is abnormal.
When assessing a child, clinicians may consider:
Walking pattern
Running mechanics
Heel position
Foot flexibility
Lower-limb alignment
Balance
Strength
Pain
Activity tolerance
Some studies have reported changes in lower-limb biomechanics with orthotic use, but these findings should not be interpreted as evidence that every child with flat feet requires an orthosis.
For the broader relationship between flat feet and movement, see:
Flat Feet and Walking: How Foot Mechanics Affect Movement
Flat feet do not necessarily cause pain.
Many children with flexible flat feet are completely comfortable.
When pain occurs, however, it is worth identifying:
Where the pain occurs
When it occurs
Whether activity triggers it
Whether one foot hurts more
Whether there is swelling
Whether the foot is flexible or rigid
Pain is one of the main reasons that a child with flat feet may require further assessment or supportive treatment.
Consider professional evaluation when:
Flat feet are painful
Pain is persistent or recurrent
The child avoids physical activity
Walking or running is difficult
The foot appears rigid
One foot is significantly different from the other
There is swelling
The foot shape is changing noticeably
Symptoms interfere with school, sports or everyday activities
There are other neurological or musculoskeletal concerns
A healthcare professional can determine whether the child's foot represents normal flexible flatfoot or whether further investigation is warranted.
Not necessarily.
A painless, flexible flatfoot in an otherwise healthy child may not require extensive testing.
However, examination becomes more important when there are symptoms or unusual findings.
Research reviewing pediatric flatfoot measurement has found that there is no universally accepted single diagnostic definition, reinforcing the importance of considering the child's overall clinical picture rather than relying on one measurement or footprint test.
No.
A wet-foot test can show how much of the foot contacts the ground, but it cannot determine whether a child needs arch support.
It also cannot reliably tell you:
Whether the foot is flexible or rigid
Whether the child has pain caused by the flatfoot
Whether the posterior structures are functioning normally
Whether treatment is required
Which type of orthosis would be appropriate
For general information about the test:
Wet Foot Test: How to Check Your Arch Type at Home
There is not enough evidence to say that routine arch support prevents normal childhood flexible flat feet from progressing.
The purpose of an orthosis in a symptomatic child should generally be symptom management and functional support rather than promising prevention of natural arch development.
The current pediatric consensus specifically recommends orthoses for symptomatic relief and not for structural arch correction.
Not necessarily.
For routine flexible flatfoot, current pediatric guidance recommends prefabricated orthoses as the default when orthotic treatment is indicated. Custom orthoses may be considered for selected children with atypical foot morphology, certain medical conditions or failure to respond to prefabricated devices.
The most expensive or highly customized option is therefore not automatically the most appropriate one.
There is no universal duration that applies to every child.
The duration depends on:
Why the orthosis was prescribed
Severity of symptoms
Type of orthosis
Child's activity
Response to treatment
Advice from the treating professional
An orthosis should be monitored for comfort and effectiveness rather than worn indefinitely simply because a child has flat feet.
This depends on whether the child has symptoms or a specific clinical reason for using them.
If an orthosis has been recommended, it should generally fit securely inside the sports shoe and not cause pain, pressure or instability.
A child who develops pain during sports despite wearing an orthosis should be reassessed rather than simply increasing the amount of support.
The most important thing to understand is that flat feet are not automatically a problem.
For many children, particularly those with flexible and painless flat feet, the arch develops naturally with growth and routine treatment is unnecessary.
Arch support may become relevant when there are symptoms or functional limitations.
Think about it this way:
Flat feet alone ≠ automatic need for arch support.
Flat feet + persistent symptoms/function problems = worth assessing.
And:
Arch support ≠ guaranteed arch correction.
When orthoses are appropriate, the goal is generally to improve comfort and function rather than force a child's foot into a particular shape.
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