My Child Has Flat Feet — Should I Worry?

Almost all children under three have flat feet — the arch is hidden by a soft fat pad and the foot is still developing. By age 6, most children have a visible arch when they tip-toe or sit. By age 10, the adult arch is usually established. Some children, and around 1 in 5 adults, simply have flexible flat feet for life — and that's normal, not a deformity.

Flat feet that are almost certainly fine

• Your child has no pain and isn't complaining
• They keep up with friends when running and playing
• The arch appears when they go up on tip-toes
• Their walking pattern looks even and symmetrical
• Shoe wear is reasonably even on both shoes

Signs to get assessed

• Foot, ankle, knee or leg pain — especially after sport or at the end of the day
• Frequent tripping or asking to be carried more than expected for their age
• The arch stays flat even on tip-toes (a 'rigid' flat foot)
• One foot looks very different from the other
• Visibly rolling-in ankles, with the knees pointing inwards when walking
• Heel pain in active 8–14 year olds — often Sever's disease, very treatable

What a paediatric assessment involves

We watch your child walk and run, check joint flexibility, look at how the foot loads, and listen to what the child describes (in their own words). We then explain clearly whether anything needs treatment — most of the time the answer is reassurance and a few sensible footwear tips rather than orthoses.

What about insoles?

Insoles are not routinely needed for painless flat feet — there is strong evidence they don't change the long-term shape of a child's foot. They are useful when the foot mechanics are clearly causing pain, when one side is significantly more loaded than the other, or for specific conditions like Sever's disease (heel pain) and juvenile bunions.