Flat Foot

Structural signs of flat foot in children

• The inner arch disappears when your child stands, but comes back when they sit, tiptoe, or lift the foot off the floor (flexible flat foot).
• From behind, the heels tilt outward (valgus) instead of staying straight — most visible when barefoot on a hard floor.
• A wet footprint on the bathroom floor shows the whole sole, with little or no inward arch curve.
• The inner edges of school shoes are crushed flat or worn faster than the outer edges, often within months.
• The inner ankle bone looks more prominent on one or both sides than it does on flat-arched adults you know.
• Knees naturally turn inward (knock-knees) when standing — often paired with flexible flat feet.

Why flat-foot timing matters in kids

Most children are born with flat feet. The arch usually starts forming from around age 5 and continues developing into early teens. Some children never develop a visible arch and remain perfectly healthy — pain, fatigue, or visible heel tilt are what change the picture.

While the foot is still flexible, the arch responds best to consistent support. Once growth slows, the same support takes longer to make a difference.

How we approach it for kids

A paediatric foot assessment takes 20 to 30 minutes: 3D foot scan, walking observation, posture review with the parent present.

If arches would benefit from support, we craft a custom insole designed for a growing foot. Replacements are built in as your child's feet grow.

What to check in adults

• No visible arch on the inside of your foot when you stand barefoot on a hard floor.
• Inner ankle swelling or tenderness, especially after a full day standing.
• Looking at your foot from behind, you see more toes on the outer side than on the other foot.
• You cannot comfortably rise onto the toes of one foot while standing on it.
• The inside edges of your shoes are crushed inward or worn flat within a few months.
• Arch or inner-ankle pain that gets worse after walking, not better.

Why adult flat foot needs a different approach

In adults, flat foot is usually one of three things: a flexible arch that has been low since childhood, a fallen arch that has progressed gradually (often called posterior tibial tendon dysfunction, PTTD), or a rigid flat foot from arthritis or injury. The structure has set — an insole supports it but does not rebuild the arch.

Left unsupported, the inward roll (overpronation) loads the inner knee, the hip rotators, and the lower back. Most adult flat-foot complaints we see are not about the foot itself but the joints above it.

How we approach adult flat foot

The 20 to 30 minute assessment maps your specific arch height under load (standing, not sitting) and your gait pattern. We check for ankle tilt, big-toe push-off, and inner-knee tracking before designing.

Custom insoles include medial arch support sized to your actual collapse height, a heel cup to control inward tilt, and forefoot balance to keep push-off straight. Daily wear matters more than aggressive design.