It is generally understood that babies are born with flexible flat feet and the mature foot is usually reached at around 7-10 years of age. Throughout the first decade of life, a child’s arch is progressively developing. During development ages, foot and arch pain are usually related to skeletal maturity and are generally age-specific. During growth and maturation, both foot size and strength will develop and motor skills will also improve.

Common Causes

• Active pediatric population: minor trauma or repetitive stress is combined with abnormal biomechanics. 
• Sever’s disease/Calcaneal apophysitis (heel pain): very common in children aged 10-13. Often due to repetitive stress at the growth center of the heel.
• Skeletally immature patients: 
  • Pes planus (flat feet): no or minimal longitudinal arch is common in children up to age 7. The majority of children with flat feet are asymptomatic, as it is usually a transitionary period and generally not a cause for concern.
  • Calcaneal apophysitis (heel pain): very common in children aged 10-13. Often due to repetitive stress at the growth center of the heel.

How Physiotherapy Can Help

• Pain management
• Strengthening surrounding musculature to help reduce any gait or positioning abnormalities
• Strengthen the intrinsic foot muscles to help maintain a good foot arch
• Active or passive stretching of the surrounding musculature
• Overall leg alignment improvements to encourage arch development and reduce reliance on flat foot position