Flatfoot (Pes Planus)

Gillette has one of the largest pediatric orthopedic groups in the country. Our Center for Pediatric Orthopedics offers comprehensive diagnosis, treatment and management of flatfoot in children and teens.

By providing care in a family-centered environment, we help our patients achieve their highest possible levels of independence, comfort and happiness.

Why Choose Gillette?

  • Gillette is nationally and internationally recognized as a leader in pediatric orthopedics.
  • We offer the expertise of one of the largest groups of fellowship-trained pediatric orthopedic surgeons in the nation.
  • Our facilities and technology—including state-of-the-art surgery suites and one of the nation’s first and busiest centers for gait and motion analysis—are designed specifically for your needs.
  • We believe that all children deserve a lifetime of excellent health care—from birth through adulthood.


Flatfoot (pes planus) is a condition in which the arch of the foot disappears when standing or when the entire sole of the foot meets the ground. In some cases, as the arch disappears, the ankle rolls inward (pronation).

Flatfoot Types and Causes

There are two types of flatfoot seen in children.

  • Flexible flatfoot: Most children who have flatfoot have this type; it’s often a normal part of development. Infants and toddlers typically have little to no arch. Most children develop normal arches by age 10. Flexible flatfoot usually doesn’t cause pain or disability and doesn’t require treatment. It affects both feet.
  • Rigid flatfoot: This rare type of flatfoot often develops in children who have problems with the bones in their feet. It affects both feet in roughly half the cases of rigid flatfoot. Children who have rigid flatfoot might experience more severe symptoms, such as pain or cramping.

Sometimes conditions such as cerebral palsy or fused tarsal bones cause abnormal development of the foot, leading to flatfoot.

Flatfoot Symptoms

Both flexible flatfoot and rigid flatfoot can cause symptoms (be symptomatic) or cause no symptoms at all (be asymptomatic). Most children who have flatfoot experience no symptoms. When children who have flatfoot experience symptoms, some of the most common include:

  • Changes in walking patterns
  • Heels that tilt outward
  • Cramping in the feet or legs
  • Pain or tenderness in the foot, ankle or lower leg when walking or during activity

Children might also withdraw from sports or physical activities that cause pain in their feet or legs.

Flatfoot Diagnosis and Tests

To diagnose flatfoot, our specialists begin with an examination of the foot and ankle. We’ll ask if pain is present in a specific area of the foot.

To diagnose flexible flatfoot in children—the type that needs no treatment—we look for an arch in the foot while the child is standing, while on tiptoe or while sitting.

We diagnose rigid flatfoot when no arch is visible while the child is on tiptoe or while sitting. We’ll also check to see if the joints in the feet and ankles move easily. If the ankle is difficult to move, for example, that might mean the Achilles tendon is tight or shortened.

We might also take X-rays to get a more detailed view of the foot if pain is a symptom.

Flatfoot Treatments

When a child has flexible flatfoot with no pain, we don’t recommend treatment. When a child has flexible flatfoot with pain or arches that ache, however, we might recommend using an arch support in shoes. Although arch supports don’t correct flatfoot, they provide additional comfort.

When a child has flexible flatfoot with a short Achilles tendon, we recommend stretching the tendon. Stretches can be part of a home exercise program or part of a physical therapy program.

In rare cases, we might recommend surgery when flatfoot causes persistent pain and tightness or when conservative treatments don’t alleviate pain. This is more common with rigid flatfoot. We typically only perform surgery to treat rigid flatfoot on older children and adolescents.


Gillette’s Center for Pediatric Orthopedics offers fellowship-trained orthopedic surgeons who specialize in caring for children, along with a vast team of experts in a variety of specialties. Together, we offer comprehensive treatment plans that produce stellar outcomes for our patients.

In addition to receiving care from our experts in Orthopedics, patients who have flatfoot might also receive care from staff in:

We also work closely with primary care providers, teachers, and school and community therapists. Our goal is to support patients and their families with a family-centered team.

For more information about Gillette’s comprehensive services, search Conditions and Care.

Why Gillette?

Because all children deserve a lifetime of amazing health care.

Why Gillette ยป