One of the most commonly asked questions by parents of children with “flat feet” is “Do they need orthotics or arch supports?” There is no simple correct answer, but let’s talk about flat feet, orthotics, some research and common sense.
Please note this article is not referring to children with congenital or birth deformities, painful conditions, poor co-ordination, clumsiness, etc but rather just the good old flat feet, fallen arches, low arches, fatty feet, rolled in feet, etc at a general level. Flat Feet is a term that is frequently over-used or incorrectly used to describe the arch height in feet or the rolling inwards of feet, which is pronation.
Orthotics are arch supports that go into shoes to help hold up the arches of the feet. Orthotics can be pre-made or custom-made. Pre-made orthotics can be bought from pharmacies, shoes stores, etc. but you will always get more corrective and longer lasting ones from a podiatrist.
Custom-made orthotics are often made from a plaster cast mould or computer scan of the feet. Podiatrists are the only health professionals who learn how to make custom made orthotics as part of their degree. You should question other health professionals claiming to sell custom made orthotics about the process, their level of follow up and modifications of past orthotics.
Often mums & dads (or even grandparents) have painful conditions in their feet or legs and orthotics have helped them. Thus, when they look at their child’s fatty, flat feet, they think that kids orthotics will help prevent pain in the future or even help permanently correct the “flat feet” so that they have perfect feet in adulthood. It is normal for young children to have low arches and as they grow, if they have the genetic programming to develop arches, they will. There is NO research that proves that giving a young child a pair of custom made orthotics will help develop the arch of the foot. In fact, there is research that disproves it!!
Research by a team of USA orthopaedic specialists in 1989 (yes it’s old, but it has never been disproven & is still referred to by specialists), looked into flat feet, shoes and orthotics – it was titled “Corrective Shoes and Inserts as Treatment for Flexible Flatfoot in Infants and Children – Wenger et al” and to summarise -
- 129 children aged 1-6 were assessed over 3 years, to see if flexible flat feet could be influenced by either orthopaedic shoes, heel cups or custom moulded inserts (orthotics).
- Their conclusion is “The results of this study confirmed that flexible flatfoot in young children slowly improves with growth and that intensive treatment with corrective shoes or inserts for a three-year period does not alter the natural history.”
Basically, wearing orthotics during school hours, sport, etc, but not at home or during the summer holidays won't result in the permanent correction of flat feet as genetics will win in the end. Orthotics are just like reading glasses, they work when you have them on, they are not like braces on teeth.