Developmental Flat Foot
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
Developmental flat foot means the arch on the inside of a child's foot is low or missing when they stand. It is very common in young children: about 44 to 54 per cent of 3 to 4 year olds have it, falling to under 15 per cent by age 10. Most children have no pain or other symptoms. The arch usually builds up by itself as they grow, so most children need no treatment, only reassurance and a watchful eye. Pain, stiffness or a limp are reasons to have the feet checked.
What is it?
Developmental flat foot means the arch on the inside of your child's foot is low or missing when they stand. In most children the foot is flexible. The arch shows up when the foot is off the ground, such as when your child sits, or when they stand on tiptoe. This is a normal part of growing, not a disease.
All typically developing children are born with flat feet. Their arch builds up gradually over the first ten years or so. A flat foot is a normal finding in young children, and it becomes less common with age.
A rarer type is rigid (stiff) flat foot. Here the arch stays flat even when the foot is off the ground or your child is on tiptoe. This type can be linked with a problem in the foot, so it needs to be checked by a health professional rather than simply put down to growing.
Who does it affect?
Flat feet are most common in young children. About 44 to 54 per cent of children aged 3 to 4 have them, and by age 10 this falls to under 15 per cent. Estimates of how many children are affected overall vary, because they depend on the age of the children and how the arch is measured.
Some children are more likely to have flat feet that last. This includes children with very loose joints, children with a family history of flat feet, and children who are overweight.
Signs and symptoms
The main sign is an arch that disappears when your child stands. The middle of the foot sinks towards the ground, and the heel may tilt outwards.
Flexible flat feet usually cause no symptoms at all. When they do cause trouble, children may have:
- pain or tiredness in the feet, legs or ankles, especially during or after activity
- stiffness or swelling
- more tripping or falling than other children
- shoes that wear unevenly around the inside of the heel
Rigid flat feet are more likely to cause pain and difficulty walking. Redness, heat and swelling are not typical of flat feet. If you see them, your child needs to be checked.
What causes it?
Mostly it is just normal growth. Children's feet have looser ligaments (the bands that hold joints together) than adults' feet. They also have more fat in the foot, which can hide a developing arch, and the muscles that control the foot are still maturing.
Often there is no obvious cause. It may just be the way your child's feet are, and it sometimes runs in families. Being overweight is linked with flat feet that last, although how strong this link is isn't fully clear.
How is it diagnosed?
Flat feet are diagnosed from your child's history and an examination. Your podiatrist or doctor will ask about any pain, tiredness or tripping. They will look at your child's feet while they stand, sit and walk, and check whether the arch appears when the foot is off the ground or on tiptoe. They may also look at your child's shoes and check their general movement and joints.
X-rays are sometimes ordered to look at the bones of the foot. There is no single agreed test or cut-off for flat foot in children, so your podiatrist will look at the whole picture, including your child's age.
Treatment
Most children with flexible flat feet have no symptoms and need no treatment.
Looking after it at home
If your child's flat feet are flexible and painless, the best approach is to explain that this is normal development, then watch how it goes. No treatment is needed if the arch shows when your child stands on tiptoe or when the foot is off the ground. Your child can keep playing and being active as usual.
Come back for a check if your child develops pain when walking, a limp, or any of the warning signs listed below.
Treatment from your podiatrist
Your podiatrist's first job is to work out whether the foot is flexible or rigid, and whether anything else needs checking. If it is flexible and painless, you will most likely be reassured and asked to return if anything changes.
If your child has ongoing pain or can't do their usual activities, your podiatrist will review them rather than keep waiting. It isn't clear yet how well insoles, exercises or other active treatments work for children with painful flat feet. Your podiatrist can talk through the options that suit your child.
Other options
A rigid or painful flat foot in a child older than 3 that limits activities such as running or jumping may need referral to a hospital clinic for a specialist assessment. So may toe walking that comes with other findings, such as a stiff ankle or a difference between the two sides.
Recovery
The outlook is good for most children. The arch usually develops by itself, often by about age 6, though for some children it takes until about age 8 to 10. Most children have a strong, normal arch by about 10 years.
Only a small number of children are still affected: about 4 per cent of ten-year-olds have flat feet that last or get worse, and fewer than 2 per cent have pain. After about age ten, a flat foot that is still there and causing symptoms should be assessed, because it can become stiffer over time.
When to see a podiatrist
When to book
Your child's flat feet seem to cause tiredness or discomfort in the feet or legs, they trip or fall more than other children, or their shoes wear unevenly on the inside of the heel. Book too if your child is around ten or older and the flat feet are still there or have started to cause symptoms, or if you would like someone to check that the flat feet are flexible.
When to get help sooner
See your GP or another doctor today if your child has a red, hot, swollen joint, a fever or seems very unwell, or sudden, severe pain in one joint with a limp. Do the same for a limp that has lasted more than 7 days without improving, or for a red, hot or swollen foot, especially in a child with diabetes or after an injury. Flat feet that appeared after a recent injury, or a foot shape that is getting worse, also need a doctor today. If your GP can't see you today, go to an urgent care clinic or an after-hours GP.
See your GP as soon as you can if your child has pain when walking, pain at night, or unexplained weight loss. The same goes for stiff feet, a limp, weakness or numbness, only one flat foot, flat feet that appeared after the arch was once normal, or activity that is limited by the feet. See your GP soon too if the arch never appears when the foot is off the ground or on tiptoe, or if your child walks on tiptoes and also has a stiff ankle, can't stand with heels down, has one side different from the other, has very bulky calf muscles, or seems unusually stiff or unsteady.
Frequently asked questions
How can I check at home whether my child's flat foot is flexible?
Watch your child's feet when they sit with their feet off the ground, and when they stand up on tiptoe. If an arch appears, the foot is flexible, which is the common, harmless type. If the arch stays flat, have it checked by your podiatrist or GP rather than waiting.
Is it a problem if my child never gets an arch?
Not necessarily. About 1 in 5 children never develop an arch, and for some of them flat feet are simply their normal foot shape. If the feet don't hurt and your child can do the things they enjoy, there is usually nothing to fix.
Can I do anything to help my child's weight and feet?
Being overweight puts more strain on a growing body, and it is linked with flat feet that last. It isn't clear that weight alone causes flat feet. If you have concerns about your child's weight, raise them with your GP or another health professional, who can support you without blame.