Podiatrist · Specialist in Biomechanics · Founder of VOLKAN
"The arch is not a goal that the body must achieve. It is the consequence of a developmental process that each child goes through at their own pace."
"Doctor, when will the arch come in?"
A mother asked me this question while her child played barefoot in the office.
He was running.
He was jumping.
He was tiptoeing.
He was spinning around.
He was going up and down the examination step as if it were a mountain.
While she observed his feet.
I watched how he moved.
When he finished playing, I asked him:
—Does he complain of pain?
—No.
—Does he get more tired than other kids?
—No.
—Has he stopped doing any activities because of his feet?
—No.
Then I responded to her.
—Maybe the problem is not the arch. Maybe the problem is that we are looking in the wrong place.
A flat foot is not always a sick foot
There is a very common association.
Flat foot means problem.
But the reality is much more complex.
During the first years of life, it is completely normal for the arch to be barely visible.
The presence of adipose tissue on the sole of the foot, the immaturity of the musculoskeletal system, and the developmental process itself cause many children to have an appearance of flat feet.
And that, by itself, does not indicate disease.
It is, simply, a stage of development.
The arch appears as a consequence
Many people imagine that the plantar arch suddenly emerges, like someone turning on a switch.
It does not happen that way.
The foot changes little by little.
The bones grow.
The muscles mature.
The ligaments increase their ability to control movement.
The nervous system learns increasingly efficient strategies.
The child runs.
Jumps.
Plays.
Explores.
All that process contributes to the arch gradually defining itself.
It does not appear because a certain age is reached.
It appears as a consequence of development.
The form does not always explain the function
Imagine two bridges.
From afar they look identical.
However, one perfectly supports the passage of hundreds of vehicles and the other has structural problems.
Appearance does not always reveal the functioning.
With the feet, something similar happens.
Two children may have a very similar arch.
One moves with absolute normality.
The other may experience pain, fatigue, or difficulties with certain activities.
And the opposite can also happen.
An apparently flat foot can be perfectly competent.
Biomechanics reminds us of an idea that has accompanied this entire book.
Function always deserves more attention than form.
When is it advisable to evaluate a flat foot?
That many childhood flat feet are part of normal development does not mean that all should be ignored.
There are situations that deserve a professional evaluation.
When discomfort appears.
When there is a significant limitation to play or walk.
When the foot is rigid and barely allows movement.
When the deformity progresses noticeably.
Or when there are significant differences between both feet.
Not because the arch is the problem.
But because the body is providing information that should be interpreted.
Observation is still much more useful than alarm.
What does this have to do with barefoot?
A lot.
A foot that is still learning needs opportunities to move.
To use its toes.
To perceive the ground.
To constantly reorganize its balance.
Excessively rigid or very limiting footwear can reduce some of those opportunities.
That does not mean that all children should exclusively wear barefoot footwear.
It means that, when conditions allow, footwear that respects the natural mobility of the foot tends to promote a freer development of its functions.
The goal is not to create an arch.
The goal is to allow the foot to keep learning.
What I see every day in consultation.
Often families arrive worried because their child's arch "hasn't come out yet."
After exploring the child, we often spend more time talking about their physical activity than about their feet.
Does he play?
Does he run?
Does he climb?
Does he jump?
Does he spend many hours sitting?
The answers often provide much more information than a photograph of the sole of the foot.
Because development does not occur while we observe the arch.
It occurs while the child lives.
What you can do starting today
If you observe a child's feet, try to look beyond the footprint.
Watch him walk.
Run.
Play.
Change direction.
Stand on tiptoes.
Maintain balance.
Ask yourself less about what his foot looks like.
And more about how he uses that foot to explore the world.
Because that's where the most valuable information is often found.
🔬 In a nutshell
In childhood, the function of the foot often provides much more information than the shape of its arch.
The most important idea
Flat feet in children, in most cases, are part of normal development.
The arch does not appear following an identical timeline for all children, but as a result of a complex process of growth, neuromuscular maturation, movement, and experience.
That's why, before proposing treatments or corrections, it's worth asking if that foot adequately fulfills its function.
The biomechanics do not aim to build a perfect arch.
It aims to help a child move, play, and develop with freedom, safety, and confidence.
Because a healthy foot is not defined solely by its shape.
It is defined, above all, by what it is capable of doing.
A question to reflect on
Think of a child playing in a park.
What tells you more about the state of their feet: the shape of their arch… or the joy with which they run, jump, and explore without fear?
Perhaps the answer is in front of us long before we look at a footprint.
In the next article…
There is a phrase I often hear in consultation.
"They have been given insoles because they have flat feet."
But is that a sufficient reason?
Do the insoles make the arch appear?
Do they modify the development of the foot?
When are they really indicated?
In the next chapter we will address one of the most debated topics in pediatric podiatry and discover that an insole should not be prescribed to change the shape of a foot, but to help a function when it really needs it..