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 should range in cost from $30-$100 and can be bought from pharmacies, shoes stores, etc but you will always get more corrective and longer lasting ones from a podiatrist or other health professional.
Custom-made orthotics should range in cost from $320-$500 a pair and 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 (we know it’s old, but we don’t know of any new research that disproves this study), 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”. They studied 129 children (98 to completion) aged 1-6 for a minimum of 3 years, to assess whether flexible flat feet could be influenced by either corrective 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.” Read more here. Common sense dictates that you can’t give a child a pair of kids orthotics to be worn between the hours of 8am to 4.30pm when they are at school and never worn during summer or when at home and expect to get a permanent change so that when they grow up, they have nice high arched feet. If you want a permanent change, you have to attach something permanently – e.g. orthodontic braces for teeth or calipers for club feet. These devices are attached permanently and periodically adjusted to move teeth and bones into a different place. To do that for a child’s “flat feet” is archaic (e.g. Chinese foot binding) and not recommended for flat


To answer this truthfully will probably annoy some health professionals, but here goes. The answers can include but are not limited to – lack of awareness of the research, inexperience of the alternative treatment options, lack of skill diversity and last but not least, the money – yes, health professionals make money out of orthotics and custom-made kids orthotics can be seen as a cash cow.


Put them into good shoes that are stable at the heel cup, stable in the midsection and protect them from the modern world. Also, let them run around barefoot on natural surfaces as this helps develop proprioception. If their feet are outside the ideal ranges of “flat feet” or pronation, then by all means see a podiatrist experienced in orthotics and more often than not a pair of pre-made orthotics will be sufficient to support the feet and make them function better. Pre-made orthotics can improve co-ordination, stability, ungainly running and general clumsiness. This less expensive option allows for replacement pairs as the child’s feet grow. Please remember, that we are not talking about children with specific disorders of conditions of their feet as these may need custom-made kids orthotics – see this 10 year old girl with a bunions at her big toe joints and a family history of bunions.
In conclusion, “flat feet” is a perfectly normal stage of development, orthotic supports will not permanently alter the arch height as what is genetically programmed to occur will win in the end, but even pre-made orthotics will help improve function, co-ordination, stability, clumsiness, etc.
Children with growing feet should only be fitted with custom-made orthotics in exceptional circumstances such as diagnosable conditions, pain, development disorders, etc. Once children’s feet stop growing (usually 13 for girls and 16 for boys), then custom-made orthotics become more financially viable as they should last around 5 years. Should you have any concerns or questions about you or your child’s feet, please call us on the following number and we will give you our honest professional opinion – 1300 1 2 FEET. You can also see Stewart Hayes discuss this topic here. Click here for the Google Reviews of our podiatrists

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