A parent’s guide from Bayshore Podiatry Center in South Tampa.

Quick take

• A flat-looking foot is common in young children and is often normal.
• The deciding factor is usually pain and function, not “how the arch looks.”
• Inserts can help comfort in some kids, but they don’t “create” an arch.
• A painful, stiff “flatfoot” is different and deserves evaluation.

Table of contents

• Why so many kids look flat-footed
• Flexible vs rigid flatfoot
• What parents should watch for
• What you can do at home
• How we evaluate flat feet
• Treatment options (least to most invasive)
• Common myths
• FAQs
• Sources

Why so many kids look flat-footed

Parents are often told to “watch the arch.” That’s not wrong, but it’s incomplete.

A child’s foot is still developing. Many kids have extra soft tissue under the arch and looser joints early on, which makes the foot look flatter when they stand. As they grow, the shape and strength of the foot changes and the arch often becomes more visible.

The main question we care about is this:

Is your child comfortable and active, or is the foot limiting what they can do?

Flexible vs rigid flatfoot (this matters)

Flexible flatfoot

A flexible flatfoot means the foot looks flatter when standing, but the joints still move normally.

A simple at-home clue: when your child stands on tiptoes, an arch often “shows up.” When they sit, the foot often looks more normal. This pattern is typically reassuring.

Flexible flatfoot is often a normal variant when it is painless.

Rigid flatfoot

Rigid flatfoot is different. The foot stays flat and stiff, and the motion in the hindfoot is limited. This pattern is more likely to cause pain and may be linked to structural issues such as a tarsal coalition.

If your child has a flat foot plus stiffness plus pain, don’t treat it like routine “flat feet.”

What parents should watch for

Reassuring signs

• Your child has no pain.
• They run, jump, and play without limitation.
• The feet are similar side-to-side.
• The foot is flexible (arch appears on tiptoes, normal motion at the ankle and hindfoot).

Signs it’s worth evaluating

• Pain during sports, long walks, or standing for long periods.
• Frequent ankle rolling combined with pain.
• One foot looks noticeably different than the other.
• A foot that looks stiff or “locked.”
• Pain that persists despite a short period of reduced activity and supportive shoes.

Have concerns? Book an appointment now! 

What you can do at home (first 10–14 days)

If your child has mild discomfort, start with simple steps before you escalate.

1) Reduce the load, not the movement

Most kids don’t need complete rest. They often do need a temporary reduction in high-impact activity (running, jumping, long practices) while symptoms calm down.

2) Improve support

• Use a supportive, well-fitting shoe for daily wear.
• Avoid long periods barefoot during a flare.
• If pain is present, a simple over-the-counter insert can be reasonable for comfort.

3) Address tightness and capacity

Many kids with foot pain have tight calves, low tolerance for sudden activity spikes, or both.

• Gentle calf stretching (no forcing) can help.
• Age-appropriate strengthening can help overall lower-extremity control.

If pain worsens, if limping develops, or if symptoms persist beyond a couple of weeks, it’s time to be seen. You can book here! 

How we evaluate flat feet in clinic

We keep it practical and parent-friendly.

History

• Where is the pain, and what triggers it?
• What sports and training volume are involved?
• Any recent change in activity?
• Any family history of foot structure issues?

Exam

• Flexibility of the foot and hindfoot motion
• Achilles/calf tightness
• Tenderness location
• Gait assessment (how the foot functions, not just how it looks)

Imaging (only when needed)

Many flexible, painless flat feet do not require imaging.

If pain is significant, the foot is stiff, or the presentation is atypical, imaging can help rule out structural causes.

Treatment options (least to most invasive)

1) Education and reassurance (often the right answer)

If the flat feet are painless and your child is thriving, over-treatment creates more worry than benefit.

2) Shoe and activity adjustments

Supportive shoes and temporary reduction in impact can calm symptoms during flare-ups.

3) Inserts / orthoses (for symptoms, not “arch building”)

This is where many parents get mixed messages.

Inserts can help comfort in some children with activity-related pain. They do not reliably “create” an arch or permanently change foot shape. If the goal is comfort and better tolerance for activity, a trial can be reasonable.

4) Physical therapy / targeted rehab

If mechanics, flexibility, or strength are contributing to symptoms, guided rehab can be very helpful.

5) Immobilization (selected cases)

If pain is significant, short-term immobilization may be used to calm inflammation and protect the foot while we clarify the diagnosis.

6) Surgery (uncommon; reserved for specific situations)

Surgery is not a first-line solution for routine flexible flatfoot. When surgery is considered, it is usually for specific structural problems or persistent, function-limiting pain that has not improved with appropriate conservative care.

Common myths

Myth: “Flat feet always cause problems later.”

Truth: Many children with flexible flat feet have no pain and no functional limitations.

Myth: “Inserts build arches.”

Truth: Inserts may improve comfort in some cases, but they do not reliably create a permanent arch.

Myth: “If the arch looks flat, the child needs custom orthotics.”

Truth: The presence of pain and functional limitation matters far more than appearance alone.

FAQs

Will my child outgrow flat feet?

Many children develop a more visible arch as they grow. The more important question is whether the foot is painful or limiting activity.

Do inserts weaken the foot?

Not inherently. The bigger issue is using support without also improving overall tolerance for activity (strength, mobility, gradual progression).

Should we stop sports?

Usually no. We often modify impact temporarily, then build back.

When to book an evaluation

If your child is limping, avoiding activity, or has persistent pain, we can help you sort out whether this is a normal variant, an overuse flare, or a structural issue that needs targeted treatment.

Bayshore Podiatry Center serves families across South Tampa and Hyde Park. You can book with us by clicking here!

Medical disclaimer

This article is educational and does not replace individualized medical advice. If your child has severe pain, deformity, fever, or cannot bear weight, seek urgent care.

Sources

• Mosca VS. Flexible flatfoot in children and adolescents. J Child Orthop.
• Evans AM, et al. Foot orthoses for treating paediatric flat feet. Cochrane Database Syst Rev.
• AAOS OrthoInfo: Flexible Flatfoot in Children
• Carr JB, et al. Pediatric pes planovalgus (review).
• Vincent KA. Tarsal Coalition and Painful Flatfoot. JAAOS.