Feet are funny, they are those things at the end of your legs that hold up all of your weight all day long. They provide a stable base to balance on and the way they move when you put your weight on them helps you walk in a stable way. 

Feet come in many different variations and all feet are different! As physical therapists, when we take a first look at your child, we always make sure to look at their feet along with the rest of their body. Sometimes the way the feet are structured OR the way they move when your child stands on them can make balance VERY hard. What do we mean by this? Sometimes the feet have a little bit of extra motion to one side or the other. When this happens, the heel will often make a C shape, and that C can either point out or point in when you are looking at your child’s foot from the back. If the C’s point out, with the curve of the C in the middle, they may also have a “dropped arch” or a “flat arch”. If it looks like your child’s arch is close to the ground when you look at the inside of their foot, they may have arches that are more on the “flat” side.

Arches that are on the “flatter” end of the spectrum are not necessarily all bad, they absorb forces nicely when someone walks or runs. With enough foot strength, an arch that is on the flatter side can be very strong and can maintain that strength when challenged by difficult activities like walking, running, jumping, etc. When flat arches DO become a problem is when they start to affect a child’s balance and development of gross motor skills, like standing and walking. 

This is often the case when a foot with a flat arch lacks either the strength, dynamic stability, or both to stabilize the foot in a strong position during weight bearing. This can be seen when the child tries to stand, walk, or jump, where the arches remain in a “collapsed” position despite all the hard work the child is probably doing on top of their feet with their leg, butt, core, and trunk muscles to keep their balance. When this is the concern, we pediatric physical therapists often turn to orthotics and SMOs. When orthotics and SMOs are the right fit for your child, they allow the foot, and body on top of it, to practice dynamic stability. This helps develop a stronger foot while minimizing the effects of gravity that the foot is constantly losing the battle to! Think of it as getting the feet AND the whole body on top of the feet to work SMARTER and not HARDER for the time being! Once given a little extra help in the feet department, many kids take off and achieve milestones and new feats that were previously very challenging from them, because they are stabilizing their feet in a more efficient way.

For children who have a flat arch on one foot and not on the other, these children often have imbalances traveling from higher up in their bodies that are affecting their foot position. These children will benefit from physical therapy exercises, as orthotics won’t address the source of the problem.

If you were thinking about your child while you were reading this, come on in to KidPT for a free Discovery Visit! We can take a look at your child, how they are moving, and at their feet while they are moving! We can let you know what we are seeing and help steer you in the right direction!
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