Massage therapy · Kitchener–WaterlooFlexible Flatfoot in Children

When children with flexible flatfoot stand, the arch in the foot disappears. When they stand on their tiptoes or sit, the arch reappears. The condition is actually quite common in children, and it always affects both feet (AAOS, n.d.).

Many parents and other family members worry about an absent or abnormally low arch in their child's foot, or believe that it will lead to permanent problems or deformities. However, the condition is usually painless and doesn't interfere with walking or playing sports. Most children grow out of it without any problems (AAOS, n.d.; NHS, 2025).

Flexible Flatfoot in Children Anatomy

How to Treat Flexible Flatfoot in Children

Shoe Inserts

If the pain and discomfort continue, shoe inserts (insoles or orthotics) may help. Arch supports may relieve foot pain and tiredness, and can also extend the life of your child's shoes, which may otherwise wear unevenly. In most cases, custom-moulded arch supports give little extra benefit over cheaper off-the-shelf arch supports, which are also easier to replace as your child grows (AAOS, n.d.). I can help you work out whether your child needs arch supports and how to get them, and point you to a chiropodist or podiatrist if a custom orthotic is needed.

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Flat feet can run in families, so let the doctor know if someone else in the family has flat feet.
• The doctor may look at your child's everyday shoes for patterns of wear, and I'll look at them too.
• The doctor will check your child's Achilles tendons for tightness and may look for calluses (areas of hard skin) on the bottom of the feet.
• To make an accurate diagnosis, the doctor will examine your child to rule out other types of flatfoot that may need treatment, such as rigid flatfoot.
• If your child has any muscular or neurological (nerve) condition, make sure to let the doctor know, as some of these conditions can cause the feet to flatten (AAOS, n.d.; NHS, 2025).

Flexible flatfoot is a normal variation, and most children grow out of it. Massage and exercise don't change the shape of the foot, so if your child has no pain, there's nothing to fix. When the feet or legs ache or tire with activity, my aim is to ease those symptoms, loosen tight calves and build strength and stamina so your child can keep playing comfortably.

I start by watching how your child stands, walks and runs, checking that the arch comes back on tiptoe, checking calf flexibility and leg strength, and looking at their everyday shoes. If a foot is stiff, only one foot is affected, or something doesn't fit with flexible flatfoot, I'll suggest seeing your family doctor or nurse practitioner. For a younger child, you approve the care; parents are welcome to sit in, with your child's agreement.

On the Table

• Warmth first, then gentle massage for the calf and the muscles down the outside of the lower leg
• Calf stretches using the heel, not the front of the foot, as the lever, so the arch isn't pushed down further
• Brisk, stimulating work for the muscles along the front and inside of the shin and in the sole, and no mobilising of the already-loose joints of the inner arch
• Easing knees, hips or back if they ache from compensating

At Home

1. American Academy of Orthopaedic Surgeons (n.d.) Flexible flatfoot in children. OrthoInfo. Available at: https://www.orthoinfo.org/diseases--conditions/flexible-flatfoot-in-children/ (Accessed: 7 October 2026).
2. NHS (2025) Flat feet. Available at: https://www.nhs.uk/conditions/flat-feet/ (Accessed: 7 October 2026).