Children and Flat Feet? Is It Serious?

Although flat feet is a common deformity it is not to be ignored (Bresnahan, 2020). Every step on a deformed foot leads to excessive tissue strain and further joint damage (Bresnahan, 2020).
Foot and ankle specialists know that sooner or later, flat and misaligned feet will slowly lead to other pathologies within the foot and ankle and structures. We are told to take 10,000 steps a day, to keep healthy (Bresnahan, 2020). On a foot that is not working as it should, this can cause many problems.
The stability and alignment of the foot is very important because the foot is the foundation to the upright body (Bresnahan, 2020). Failure to identify and treat foot and ankle instability and misalignment will lead to long-term tissue pathology (Bresnahan, 2020). For example tissue strain leads to pain, increased deformity, and eventually decreased activity level (Bresnahan, 2020). The body’s metabolic rate decreases as a result which leads to other health risks such as obesity, diabetes, hypertension, and heart disease (Bresnahan, 2020).
Visible signs to look out for:

• lowering of the medial arch of the foot
• excessive pronation of foot when walking (rolls inwards too much)

Asymptomatic pediatric flatfeet eventually lead to a symptomatic adult flat foot. There is documentation that adult flat feet continue to progressively get worse throughout life (Bresnahan, 2020).
Flat feet can lead to:

• Growing pains
• Shin splints/ Medial tibial stress syndrome
• Knee problems
• Hip problems
• Pelvic tilt
• Back misalignment
• Plantar fasciopathy
• Posterior tibial tendon insufficiency
• First ray deformities
• Hallux limitus
• Tarsal tunnel syndrome
• Posterior tibial tendon dysfunction

If there is an imbalance of force acting within a joint, eventually those excessive forces will have a negative impact on the cartilage until the cartilage is damaged (Bresnahan, 2020). If the forces aren’t normalized, that damage becomes chronic eventually leading to irreversible changes. It makes sense therefore to eliminate the tissue strain to prevent the partial rupture, to balance the joint facets to prevent arthritis, and to improve the biomechanics of the foot (Bresnahan, 2020).
What you can do:

• Muscle strengthening exercises have low reliability through research (Bresnahan, 2020).
• Arch supports have shown very short-term positive results in reduction of symptoms but longer follow up is lacking (Bresnahan, 2020).
• Minimally invasive joint sparing surgical procedure, there are numerous studies that have provided the evidence basis, safety and effectiveness of this (Bresnahan, 2020).

But what else can I try if you dont want surgery?
Chiropractic. As chiropractors we deal with the alignment of bony structures to help the movement of these bones in order to remove any nerve interference from the central nervous system. Based on a study done by Niazi, 201,5 that has shown that when we as chiropractors adjust subluxations, we improve strength, we prevent fatigue and we change the way the brain drives our muscles.
Pediatric flatfeet should not be ignored or downplayed. The sooner effective treatment is prescribed, the less damage will occur to other parts of the body. When possible, a more conservative corrective procedure should be performed prior to irreversible, joint destructive options.

References:
Bresnahan, P. J., & Juanto, M. A. (2020). Pediatric Flatfeet-A Disease Entity That Demands Greater Attention and Treatment. Frontiers in pediatrics, 8, 19. https://doi.org/10.3389/fped.2020.00019Niazi, I.
K., Türker, K. S., Flavel, S., Kinget, M., Duehr, J., & Haavik, H. (2015). Changes in H-reflex and V-waves following spinal manipulation. Experimental brain research, 233(4),1165–1173. https://doi.org/10.1007/s00221-014-4193-5