Is it normal for my children to have flat feet, or walk with an out-toeing, or in-toeing gait?

Most children are born with normal-sized feet. The shape, size, and form of the foot are determined genetically, but are also influenced by other factors. These conditions are referred to as congenital disorders.

  • The natural process of bone formation (ossification) begins with the larger bones of the foot and leg and progresses to the smaller bones.

A child’s foot is not a miniature version of an adult’s foot.

  • It is shorter and wider at the toe and tapers toward the heel.
  • The infant’s foot is malleable.  This enables some congenital deformities to be easily corrected.
  • The foot appears fat, short, broad, and with stubby toes.
  • It appears flat due to the fatty padding in the arch region; however, this padding is gradually absorbed as growth continues.
  • Restrictive footwear should be avoided to allow for normal growth and development.  This is crucial for the development of muscles, as it allows for freedom of movement. It is recommended that children do not wear shoes until they can walk competitively outside.

Children developing flat feet is a typical developmental milestone.

Gait and general posture constantly change in the developing child. During their normal development having knocked knees, bowlegs, and a broad base of gait are all typical developmental variations. These are considered normal at specific developmental stages.

It is essential to determine whether these variations represent normal or abnormal growth. This is one of the reasons why it is essential to understand children’s developmental milestones.

Children develop flat feet for the first time when they begin to stand. This is approximately at 10 months of age. Identification of gait patterns begins between 12 and 18 months. This is the age range at which a child starts walking. As well as gross asymmetry, abnormal movement patterns such as toe walking, uncoordinated and poorly controlled movements of the lower limb, and gross asymmetry may be observed.

During the crawling and walking stages bare-footed walking is best to encourage normal function.

A young child walks with a broad base, appears flat-footed with bowlegs, the lower aspect of the spine is inwardly arched, the abdomen protrudes, and the knees are partially bent.

Children with knocked knees between the ages of 2 and 6 are considered normal. Knocked knees should resolve between the ages of 5 and 6 years. Likewise, bowlegs that appear after the age of 2 are considered abnormal.  The presence of Rickets or Blount’s disease may be indicated by excessive bowing after this age range

Numerous foot pathologies observed in children of this age are related to growth. Girls reach their peak growth rate at age 12 whilst boys reach theirs at age 14.

The growth rate of feet is constant from birth until the mid-teens, increasing by approximately two sizes per year for the first four years and then by one size per year thereafter.

As there are numerous foot types, footwear should be fitted by an experienced, knowledgeable fitter with a variety of styles, sizes, and fittings.

The foot of an infant is triangular. As the child progresses into adolescence shape becomes rectangular.  The typical foot types include hypermobile, low arched or high arched.

If your child has pain, is clumsy or you have a history of foot problems in your family then an assessment with one of our Podiatrists may be indicated. They can advise you on what action should be taken. Fill in the contact form to find out more: 


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