The [Not So] Straight Line from Flat Feet to Heel Pain in Children

There are many conditions that are said to “run in the family,” such as bunions, hammertoes, and plantar fasciitis.

But if we are to be more specific here, it’s not like babies are born with any of the above conditions right out of the gate. What they can be born with is instability or abnormality that can eventually lead to such conditions.

And among abnormalities, flat feet and overpronation – which often go hand-in-hand – are frequently the gateway to future trouble. It frequently begins with heel pain, but can also evolve into bunions, hammertoes, and other deformities.

This might sound like a bad omen, but in many ways, it’s a blessing in disguise. Because when we can identify flat feet and overpronation early, we can address them in ways that can keep future problems from developing or, on the off chance that we can’t do so fully, drastically reduce the impact they will have on your child’s life. It’s a lot like having a natural warning system.

How Flat Feet and Overpronation Can Cause Additional Problems

Flat feet occur when the arch of the foot collapses so that most or all of the arch area of the foot touches the floor. In many children, you may see a “flexible” flatfoot, in which the arch disappears while standing and walking, but magically reappears when they sit or rise up onto their toes.

Flat feet are frequently accompanied by overpronation. This is when the foot rolls too far inward during the walking cycle. 

Both of these abnormalities steadily place excess stress on areas of the foot. One of the places this can end up being felt the most is the plantar fascia, which runs along the underside of the foot and through the arch area. When this tissue becomes strained and injured, the result is heel pain that is frequently at its worst in the morning or after a long period of activity.

But the instabilities caused by flat feet and overpronation don’t just exist in the plantar fascia. They can create abnormal pressure and weight distribution against toe joints as well, which can contribute to bunions and hammertoes. Inherited instabilities for those conditions may already exist within your family as well, leading to even higher risks and worse outcomes if matters aren’t addressed sooner than later.

How to Identify Signs of Trouble in Your Child (and Not Signs of a Troubled Child)

Flat feet and overpronation are not always so easy to identify in a child. It’s highly unlikely your kid will come up to you and say, “Gee, my arch just doesn’t do what it should, you know?”

In fact, chances are very high that your child will not experience any pain or other symptoms at all until they become older. That’s certainly not a bad thing, but time is still of the essence if we want the fastest, simplest, and best results for addressing these issues.

That means it pays for you to be more attentive toward signs if and when they do develop. First, be watchful of your child’s foot and ankle structure as they stand and walk. You want to see proper, straight alignment. If you see the bottom of the back of the foot angle in and a bulge on the inside of the ankle, that is a sign of a potential problem. You can see what we’re talking about in the video below.

If flat feet or overpronation start to affect your younger child’s comfort, they may not tell you about it outright. They might either be afraid of having to get treatment, or it’s simply all they know at this time.

Watch for signs such as:

  • Lagging behind and losing interest easily in activities (especially if they’re activities your child used to love).
  • Asking to be picked up early.
  • Wanting to stop play before everyone else.

Once your child becomes older, such as around ages 9-12, signs such as heel pain may become more obvious. They may develop plantar fasciitis or Sever’s disease, the latter being a cause of heel pain that tends to be seen in active kids at this age. You may see your child running awkwardly or moving gingerly after a practice, due to their discomfort.

Addressing Children’s Foot Structures

Once again, the sooner an issue with your child’s foot structure can be identified and addressed, the better. 

The main reason for this is that your child’s structure remains much more flexible and easily influenced during younger ages. Around the ages of 4-6, for example, we can still significantly change the shape of the foot by holding it in certain positions.

Once children have developed past the age of 6, however, the structure of the foot is often unable to be so easily influenced. There is still much we can do to address symptoms and greatly slow or stop the progression of future problems such as bunions and hammertoes, but the initial problem can’t be outright “cured.” Stretching, physical therapy, and custom orthotics are some of the techniques we may recommend at this time.

Do Flat Feet Run in Your Family?

If so, then you should be paying special attention to your child’s own foot structure. Seeing flat feet at an early age is not necessarily a sign of a major problem, but it’s well worth monitoring as your child grows, so we can nip issues in the bud before they develop.

And even if flat feet don’t run in your family, please never hesitate to contact us whenever you have any concerns about your child’s foot and ankle health. We’re here to help everyone in your family get the most enjoyment out of life without foot or ankle problems holding you back.

Schedule an appointment at our Indianapolis office by calling (317) 545-0505 or by filling out our online contact form.


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Indianapolis, IN 46216

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