They do not require treatment unless symptomatic. Vitamin D deficiency: Aching pains in the limbs particularly at night time may be related to vitamin D deficiency.įlexible flatfeet are normal in children.Accessory navicular: Medial arch pain with focal tenderness over navicular.No recreation of arch on tiptoeing and the heel remains in valgus. May describe a history of recurrent ankle sprains and pain on sports. Tarsal coalition (rigid flatfoot): Painful ankle with limited subtalar motion.If the flatfoot is not flexible or significant pain exists then other diagnoses should be considered. Medial arch supports if arch pain is present on standing or walkingįlexible flatfeet are usually bilateral and rarely cause significant pain.Stretches for children with a tight Achilles tendon.Reassurance that this is a normal variant. Stretches for a tight Achilles tendon can commonly resolve symptoms. They do not alter the way the foot develops or affect the risk of future musculoskeletal problems. Treatment with arch supports in these circumstances can reduce these symptoms. Tightness of the Achilles tendon can make the foot stiffer and cause pain as a result. In a small proportion of older children, there can be aching in the arch of the foot and the ankle on prolonged standing or walking. The arch of the foot usually takes up until 10 years of age to completely develop.įlexible flatfeet are normal and do not require treatment as a routine. This is present in 90% of 1 year olds and up to 20% of adults. Right: Photographs showing the same feet on tiptoe stance with restoration of the arch of the foot and the heel tilting in to varus (towards the midline).įlexible flat feet are normal variants caused by increased flexibility of the joints and ligaments of the foot. Left: Photographs showing flexible flatfeet on standing with collapse of the medial arch of the foot and the heel in a valgus alignment (pointing away from the midline). When on tiptoes, the arch is recreated and the heel swings in to varus. This describes a loss of the medial arch of the foot with valgus alignment of the heel on standing. Children with flatfeet are usually asymptomatic.Ī flexible flatfoot is the most common presentation in children. A flatfoot occurs when the medial longitudinal arch of the foot is not present and the heel sits in valgus.
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