We have received numerous inquiries from parents seeking treatment for their children's flat feet, all posing similar questions. Here, I have compiled them for convenient reference.
  
1. My husband's/wife's family members all have flat feet. Could my child have inherited it?
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While flat feet aren't directly inherited, they can often be associated with a condition called hypermobility syndrome, where the ankle joints and feet are unusually flexible.
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This flexibility can affect your child's ability to walk with a proper foot posture, potentially leading to flattened foot arch.
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Essentially, it means their ankles and feet are extra bendy, which can impact their walking pattern.
So, while flat feet themselves aren't inherited, the tendency toward hypermobility can be inherited.
It's important for children with flexible ankles and foot to have opportunities to walk on outdoor uneven surfaces.
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This helps them learn to balance effectively and encourages the proper use of their foot arch muscles, which are essential for developing strong, supportive arches over time.
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However, sufficient outdoor uneven surfaces exposure does not guarantee a perfect foot posture in children with hypermobility syndrome as there are other uncontrollable factors such as the proprioception (sense of joint position) and body part growth proportion, and also lifestyle factor such as body weight.
 
2. Neither my husband's nor my family members have flat feet. Why does our child have it?
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While it might seem surprising that your child has flat feet despite neither side of the family having them, there are several factors to consider.
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a) Your child could inherit a tendency towards hypermobility from a grandparent, which can affect their ankle and foot stability and contribute to flattened foot arch.
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b) Insufficient exposure to outdoor uneven surfaces during the early stages of walking can slow the development of strong foot arch muscles.
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c) A lack of physical activity could lead to muscle weakness or tightness, particularly in the calves.
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The calf muscles tightness could lead to excessive movement in the foot arches in walking and causes ligament laxity and eventually the passive structure of the foot arches - the ligaments fails to hold a proper foot structure.
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d) It's important to consider footwear choices, as inadequate support, such as certain types of shoes like Crocs, can influence foot development.
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Crocs is made of plastic sponge and it has no structural stability as a sandal to support the foot. If we check the stability of a sports shoe, the hind and mid parts are harder than the fore part.
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Crocs is soft everywhere and it is an unstable platform for the foot to step on. The foot eventually falls to the side with hollow spaces, which is the inner part. Too much falling to the inner side causes ligament laxity and eventually fallen arch.
 
3. My husband has flat feet and lives perfectly fine without treatment. He says it's not necessary for our child to seek medical attention for it. Should I be concerned about not seeking treatment? What are the potential consequences?
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When it comes to your child's flat feet, your husband's experience might seem reassuring, but it's essential to weigh the potential consequences carefully. Let me illustrate this with two stories:
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Story 1:
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Consultant: After assessing your feet, I'm afraid we're unable to correct your flat feet without surgery. They're fully rigid.
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Patient: I see. I've consulted orthopedics before, and they suggested surgery too. But the recovery time is daunting. I'm a freelance technician in the oil and gas industry, I can't afford to take 3 to 6 months off work. My family depends on my income.
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Consultant: I understand your concerns. It's common for flat feet to go unnoticed until they start causing pain, especially as we age.
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Patient: Exactly. I've had flat feet since I was young, but they never bothered me until now. The pain with every step is unbearable. And it's not like I'm extremely overweight—I'm just a regular middle-aged guy, weighing less than 90kg.
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Consultant: Unfortunately, non-invasive method such as exercise and gait retraining are no longer applicable to you. If the pain has become a significant issue for you, you are left with invasive interventions.
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Story 2:
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A woman in her mid-40s, who gave birth to her first child at 40, is now contemplating having a second child. However, she suffers from flat feet and experienced significant discomfort during her previous pregnancy.
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As she considers expanding her family, her husband, concerned about her well-being, is urging her not to undergo another pregnancy to avoid further suffering. Now, she finds herself caught in a difficult dilemma.
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While your husband may have managed without treatment, it's crucial to recognize that every individual's experience is different and to consider the potential challenges your child may face down the road.
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Flat feet may not pose an immediate threat like a heart attack or cancer, but they can diminish quality of life over time. It slowly takes a way your ability to walk and it can indeed impact daily life, affecting mobility and comfort.
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Waiting until symptoms worsen may limit treatment options and potentially lead to more significant issues down the line. It's about prioritizing your child's long-term well-being and ensuring they have the best chance at a pain-free, unrestricted life.
 
4. My child has been wearing crocs since young. Could this have caused for flat feet?
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The outsole of Crocs footwear is soft and thick making it unstable for the foot to step on, eventually the foot will lean more on the sides with more hollow space, which is the inner side of the foot. This pose a high risk of causing overpronation, especially in children with soft ankle joints or hypermobility syndrome.
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It’s an unstable design that makes it unsuitable for providing a solid base for proper walking mechanics. Additionally, while Crocs are lightweight and easy to wear, many parents mistakenly believe that lightweight shoes are beneficial for their children as it require lesser effort to ambulate.
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However, this is a misconception. A lightweight shoe is only beneficial to the children if the base of the shoes are made stable.
 
5. If crocs are not recommended, what type of shoes should my child wear?
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For young kids, the recommended footwear options are closed shoes with shoe laces and a firm heel counter. Almost all shoe with laces comes with a built in arch support if the shoe laces are tighten well.
 
Young kids may also opt for sandals with three adjustable straps (Toes, Ankle and Achilles). These types of shoes offer a stable base and holding firm to the foot, aiding children in learning to walk correctly.
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Additionally, the materials tend to be denser than Crocs, which helps prevent flipping and assist in proper foot landing and push off.
 
6. I noticed my child had flat feet at a very young age, and I bought insole (shoe inserts) for them to wear. However, even after wearing them for several years, there's been no improvement. Why?
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Insoles or shoe inserts serve as supportive orthotics rather than corrective ones. Think of them like glasses for short-sighted people: they provide support only while the insole is on, but the foot arch will disappear once the insole is removed.
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Insoles are more commonly used in Western cultures, where people wear shoes indoors as well, unlike in many Asian households who don’t wear shoes indoor.
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For the insole therapy to be effective, your child needs to wear insoles for an extended periods, ideally at least 16 hours a day, and engage in physical activities like walking and running. It is not a suitable therapy for children with a sedentary lifestyle.
 
7. My child didn't have flat feet before, but after the Covid 19 pandemic, they suddenly grew taller and have bad standing and walking posture. Why did this happen?
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During the Movement Control Order (MCO) in the pandemic, children's growth dynamics shift: while bones grow primarily due to hormonal factors, muscles rely on physical activities for development.
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With reduced activity levels during the MCO, bones may elongate, feet may grow longer and wider too.
However, muscle length growth is limited due to lack of stretch and usage, leading to weakness and tightness, particularly in the calves and the hamstrings (back of the thigh).
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To compensate for this imbalance, the body may intuitively overpronate the arches and the ankle joints, resulting in the appearance of flattening foot arch.
 
8. My child is 17 years old, and we've just discovered he/she has flat feet. Is it too late to correct it now?
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Flat foot restoration may still be possible for teenagers if their ankle joints retain flexibility. Typically, joints begin to solidify around age 11, but there are exceptions, with some individuals experiencing earlier or later solidification.
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If ankle joints remain flexible, non-invasive interventions such as exercises and gait retraining can help improve foot mechanics and potentially restore the foot arch.
 
 9. My child is an adult and has flat feet. Can it still be corrected?
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We've witnessed a 37-year-old adult successfully restored his foot arch, thanks to his unusual ankle joint flexibility. Even into adulthood, some individuals retain this joint flexibility.
Therefore, determining the potential for correction requires a thorough physical assessment before offering further advice.
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We believe every child deserves to experience the joy of a carefree childhood, just like their parents did, we are aiming to make the childhood excitement a permanent gift. We hope these answers address your concerns and provide clarity to your doubts about flat feet.
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If you have any further questions or would like to learn more about our children flat feet gait re-training program, please don't hesitate to reach out to us via WhatsApp at 012-6865664.
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