76) Paediatric Flat Feet: Do Kids Really Need Physiotherapy?
Worried your child’s feet look “flat”? You’re not alone — many parents notice their child’s arches look low and wonder if something’s wrong. The good news is, not all flat feet need treatment! In this blog, we’ll break down when to relax, when to act, and how physiotherapy can help kids develop strong, pain-free feet.
What Are Paediatric Flat Feet?
Paediatric flat feet — also known as pes planus — occur when the arch of the foot appears collapsed or very low when standing. It’s extremely common in children, especially under the age of seven, as their bones, joints, and ligaments are still developing.
Flat feet can be:
- Flexible flat feet: the most common type, where the arch appears when your child stands on tiptoes. Usually harmless and improves with age.
- Rigid flat feet: less common and may indicate a structural or neurological issue that needs assessment.
Why Do Some Kids Have Flat Feet?
Several factors contribute to flat feet in children, including:
- Genetics: often runs in families.
- Joint hypermobility: overly flexible ligaments can cause the arch to collapse.
- Muscle weakness: particularly in the calves, intrinsic foot muscles, or glutes.
- Poor footwear: shoes lacking arch support can contribute to alignment issues.
- Rapid growth: as kids grow quickly, their muscles and ligaments can temporarily struggle to keep up.
It’s important to remember — flat feet alone aren’t a problem. It’s only when they cause pain, fatigue, balance issues, or altered walking patterns that treatment may be needed.
When Should You Worry About Flat Feet?
You should consider a physiotherapy assessment if your child:
- Complains of foot, knee, or leg pain
- Walks with their feet turned in or out
- Seems clumsy or trips often
- Avoids running or physical play
- Wears out shoes unevenly
- Has visible collapse of the arch or ankles rolling inwards
If you notice these symptoms, it’s time to get checked by a paediatric physiotherapist who understands how growing bodies develop.
How Physiotherapy Helps Kids with Flat Feet
Physiotherapy plays a huge role in managing symptomatic or persistent flat feet. A physio doesn’t just focus on the feet — they assess the whole lower limb chain, including hips, knees, and posture.
1. Strengthening the right muscles
Targeted exercises help strengthen:
- Intrinsic foot muscles
- Calf muscles
- Hip stabilisers and glutes
Stronger muscles mean better arch support and balance during walking or running.
2. Improving flexibility and alignment
Tight calf muscles and Achilles tendons can worsen flat feet. Physiotherapists prescribe stretches and mobility work to restore healthy movement.
3. Gait retraining
Physios analyse how your child walks and runs using video gait analysis or simple observation, then coach proper foot placement and movement control.
4. Footwear and orthotics advice
Your physio will recommend the right footwear for your child’s activity level and foot shape. In some cases, temporary orthotics or heel wedges may help relieve strain.
5. Play-based exercises
Paediatric physio isn’t about boring drills — it’s fun and engaging! Balance games, obstacle courses, and tiptoe walking challenges are used to build strength and control.
Real-Life Example: Helping a Young Patient from Dee Why
Recently, we saw Emily, a seven-year-old from Dee Why, whose parents noticed her feet rolling inwards and her shoes wearing unevenly. Emily also complained of sore legs after sports days at school.
After a full assessment at X Physio in Frenchs Forest, we found mild muscle weakness in her arches and glutes. Through a six-week physiotherapy program — including balance games, calf stretches, and strengthening exercises — her symptoms improved dramatically. She now runs and jumps pain-free and proudly shows off her “strong arches” to her parents!
Can Flat Feet Go Away on Their Own?
Yes, for many children, flat feet naturally resolve as they grow. The arches usually start developing between ages 5 and 10. However, if flat feet are still present and causing discomfort by around age 10–12, it’s worth reassessing with your physio.
When Physiotherapy Is Most Effective
Early intervention is key. Physiotherapy is most effective when:
- Flat feet are symptomatic
- The child is active or athletic
- There’s pain, poor balance, or fatigue
- Other biomechanical issues (e.g., knock knees or pronation) are present
Treatment focuses on long-term function rather than quick fixes — helping your child build strong foundations for healthy movement into adulthood.
Home Tips for Parents
Here are simple ways to support your child’s foot health at home:
- Encourage barefoot play on safe surfaces (grass, sand) to build intrinsic muscles.
- Check their shoes regularly — kids outgrow them faster than you think!
- Limit overly soft shoes that don’t provide adequate support.
- Promote active play like skipping, climbing, and balance games.
- Stretch calves daily if your child’s heels tend to lift early when walking.
When to See a Specialist
Your physiotherapist may refer you to a podiatrist or orthopaedic specialist if:
- Flat feet are rigid or painful
- The arch doesn’t form on tiptoes
- There’s swelling or stiffness in the joints
- Pain persists despite physiotherapy
These cases may require imaging or specialised orthotic support.
Why Choose X Physio in Frenchs Forest
At X Physio, we take a holistic approach to paediatric care. Our physiotherapists understand how growing bodies move and adapt. We combine clinical expertise with playful, child-friendly exercises to make rehab both effective and enjoyable.
We also work closely with local schools, sports clubs, and healthcare providers in surrounding suburbs like Belrose, Forestville, and Davidson — ensuring each child gets the best care possible.
Final Thoughts
Paediatric flat feet are common — and in most cases, they’re nothing to worry about. But if your child is in pain, tiring easily, or struggling to keep up with their friends, a physiotherapy assessment can make a world of difference.
Our team at X Physio in Frenchs Forest is here to help your child move confidently and comfortably again. Find out more about us by CLICKING HERE
Give us a call today on (02) 9806 3077, or book online — just CLICK HERE.
FAQs About Paediatric Flat Feet
1. Are flat feet normal in children?
Yes — it’s completely normal for young kids to have flat feet. Most develop arches naturally by around age 10.
2. When should I see a physiotherapist for my child’s flat feet?
If your child complains of pain, gets tired easily, or walks awkwardly, it’s worth booking an assessment.
3. Can physiotherapy fix flat feet permanently?
Physiotherapy helps strengthen muscles, improve posture, and support better foot mechanics. While not all cases are “fixed,” most children see big improvements in comfort and movement.
4. Will my child need orthotics?
Not always. Physiotherapists usually try exercise-based treatment first, but may recommend short-term orthotics for comfort or support.
5. What age should I worry if my child’s flat feet haven’t improved?
If your child is around 10–12 years old and their arches haven’t developed — or if they’re still experiencing symptoms — it’s time for a professional review.
