Flat feet (pes planus) describes a foot with a low or absent arch when standing. In infants and young children, the arch has often not yet fully developed — fat pads, ligament laxity and immature muscle strength mean that most young children's feet naturally appear flat. For the majority, an arch gradually becomes visible through early-to-mid childhood as these structures mature.
Flexible flat feet — where an arch forms when the child stands on tiptoe but flattens again on standing normally — is the most common presentation and, in the absence of pain, is generally considered a normal variant rather than a condition requiring treatment. A smaller number of children have a rigid flat foot or ongoing symptoms, which does warrant a closer look.
Flexible Flat Feet
The most common type — an arch is visible on tiptoe or when the foot is unweighted, but flattens under load. Usually painless and often improves with age.
Rigid Flat Feet
A less common presentation where no arch forms even on tiptoe, and the foot feels stiff through its range of motion. This is more likely to need further assessment.
Family History
Flat feet often run in families and a strong family history is a common and generally reassuring finding.
Generalised Ligament Laxity
Children with more flexible joints overall often have more pronounced flat feet, usually as part of a benign, generalised pattern.
Foot, leg or knee pain, or complaints of tiredness with activity
A foot that remains flat even on tiptoe (no arch forms)
Stiffness or reduced range of motion in the foot
One foot noticeably flatter or stiffer than the other
Difficulty keeping up with peers during activity or sport
Flat feet that appear to be getting worse rather than improving with age
Assessment includes observing the foot at rest, on tiptoe, and during walking, checking joint flexibility and range of motion, and reviewing family history and any symptoms. Distinguishing flexible from rigid flat feet is the key clinical question, since it largely determines whether further investigation is warranted. In most consultations for flat feet alone, the priority is providing clear, reassuring guidance on what's normal for your child's age.
If your child has pain, a rigid foot that doesn't form an arch on tiptoe, or noticeable asymmetry between the two feet, an assessment is worthwhile. Painless, flexible flat feet in a young child rarely need urgent attention — but if you're unsure, a one-off assessment can give you clarity.
At what age should an arch develop?
There's a wide range of normal, but many children develop a visible arch somewhere between four and eight years old. Some children — and adults — never develop a very pronounced arch and have no issues at all, so age alone isn't the only factor that matters.
Do flat feet need insoles?
Most flexible, painless flat feet don't need insoles. They're generally considered where there's pain, a significant functional impact, or specific findings on assessment — not simply because a child's foot looks flat.
Will flat feet cause problems later in life?
For most children with flexible, painless flat feet, there's no strong evidence of long-term problems. A rigid flat foot, or one associated with ongoing pain, is more worth monitoring and addressing — which is exactly what assessment is for.
Is this covered by insurance?
Yes — children's podiatry assessments are typically covered by most major insurers. We work with Bupa, Aviva, WPA and others. See our
insurance page for full details.
Not sure if it's normal?
Book an assessment and we'll give you a clear, honest picture of your child's foot development.
