When my daughter was 5, she complained of knee pain when she was running. Now, she is 7 and is a very active kid who enjoys gymnastics and, sometimes, gets on the squash court with my husband. As a Pedorthist, I’ve always loved looking at her feet and how they are developing.

As you can see in the pictures below, when she is standing, her feet look flat; however, when she is sitting, her arch looks normal. She has been wearing custom foot orthotics for the past 2 years and I know she walks and runs better with them in her shoes and winter boots. In the summer, she wears a Birkenstock or Biotime sandal which fit great, offer arch support, and are durable. This coming summer her feet will be big enough to fit into an orthotic-friendly sandal for those days when she is at Canada’s Wonderland all day or when the summer camp she attends has her going with non-stop activities on her feet.

There are many opinions in the Pedorthic industry about when to treat a child who has flat feet. It is expected that babies and toddlers have flat feet– flat feet help them with stability as they are learning to walk and find their balance. As children get bigger and stronger, their arch should develop. If that does not happen and there are pain symptoms, consulting with your family or pediatric doctor is beneficial. They may then refer your child for an assessment with a Pedorthist.


An Australian Podiatrist, Dr. Angela Evans, has developed a clinical-care pathway for the pediatric flatfoot (Evans, 2008). She recommends a thorough history and then a traffic light approach to treatment. Treatment is preferred if there is a flat foot and pain complaints, monitoring only the foot development if a child has flat foot but no symptoms, and no treatment is required if developmentally the arch is normal and the child is pain free. Treatment can include appropriate footwear, over-the-counter arch support, or custom foot orthotics, as well as stretching, physiotherapy, and chiropractic treatments.


If your child has an in-toeing walk and trips over their feet when running, or doesn’t like to be active, then a Pedorthic assessment can help determine if this issue is coming from the foot or higher up the kinetic chain. Many young children grow out of an in-toeing gait and activities like ice skating and ballet can help.

If you have any concerns about your child's foot health, please get in touch with me!

References featured in this post are available upon request.