Pediatric Flat Feet Michigan

Flat feet in children are extremely common — the arch does not fully develop until ages 6–8, and “flexible flatfoot” (arch appears when standing on tiptoe) is a normal variant in most children. However, rigid flatfoot, symptomatic flatfoot causing pain or gait abnormality, and progressive deformity may require evaluation and treatment. Dr. Tom Biernacki DPM at Balance Foot & Ankle provides expert pediatric flatfoot assessment in Michigan at our Howell, Brighton, and Bloomfield Hills locations.

Normal vs. Abnormal Pediatric Flatfoot

Flexible flatfoot (most common): The arch disappears when weight is placed on the foot but re-appears on tiptoe standing. Usually painless. Arch development continues until age 6–8 and may continue developing into early adolescence. Does NOT typically require treatment unless symptomatic.

Rigid flatfoot: No arch is visible even on tiptoe. Associated with tarsal coalition, vertical talus, or neuromuscular conditions. Requires thorough evaluation and often surgical treatment.

Symptomatic flexible flatfoot: Child complains of arch, heel, or ankle pain — especially with activity. Toe walking or refusal to participate in sports. Requires treatment even though the flatfoot is flexible.

When to Evaluate Your Child’s Flat Feet

• Persistent foot or ankle pain with activity
• The child avoids running, sports, or active play
• Asymmetric flatfoot (one foot significantly flatter than the other)
• Rapid progression of deformity
• Rigid flatfoot that does not correct on tiptoe
• Any concern from a parent or school nurse

Treatment

Observation is appropriate for asymptomatic flexible flatfoot in children under 8. Arch development should be monitored at annual visits.

Custom orthotics are the first-line treatment for symptomatic pediatric flatfoot. Arch-supporting orthotics reduce arch strain and posterior tibial tendon overuse, relieving pain within 2–4 weeks. They do not “correct” the deformity structurally in older children but provide functional support. Custom orthoses are preferred over OTC insoles for children with significant deformity.

Stretching — particularly of the Achilles tendon and calf complex — is recommended for all children with flatfoot. Tight calf muscles worsen arch collapse and are a universal finding in symptomatic pediatric flatfoot.

Hyprocure (subtalar implant) — a small titanium stent inserted into the sinus tarsi — is a minimally invasive outpatient procedure that blocks excessive pronation and elevates the arch in skeletally immature patients (ages 8–14). The procedure takes under 20 minutes, is reversible, and has a 90%+ parent and patient satisfaction rate in appropriately selected cases.

Frequently Asked Questions

Schedule your child’s flatfoot evaluation at Balance Foot & Ankle in Howell, Brighton, or Bloomfield Hills, Michigan. Dr. Biernacki has extensive experience treating pediatric foot conditions with a patient and family-centered approach.