Pediatric Foot Care
Does My Child Need Custom Orthotics?
A Parent’s Guide to Children’s Orthotics, Foot Pain, Flat Feet & Growing Feet
Learn when pediatric orthotics may help, when they may not be necessary, and how a foot and ankle evaluation can help determine what is appropriate for your child.
Children’s Orthotics & Growing Feet
Does My Child Actually Need Orthotics?
Parents often notice things about the way their children stand, walk, or run long before a child complains about a specific foot problem. Maybe your child’s arches look unusually low. Their shoes wear unevenly. They complain that their feet hurt after sports. Perhaps they tire quickly on long walks, or you have noticed that their feet seem to roll inward when they stand.
It is natural to wonder whether children’s orthotics could help.
The answer depends on the child. Not every child with flat feet, unusual-looking arches, or a different walking pattern needs custom orthotics. Children’s feet change considerably as they grow, and many variations in foot shape and alignment can be part of normal development.
For children who experience pain, fatigue, abnormal pressure, difficulty participating in activities, or certain biomechanical foot problems, however, pediatric orthotics may be one part of an individualized treatment plan.
At Nationwide Foot & Ankle Care, P.C., our podiatrists evaluate pediatric foot and gait concerns at our Livonia and Royal Oak offices for families throughout Metro Detroit and Southeast Michigan.
What Are Children’s Orthotics?
Orthotics are devices worn inside shoes to provide support, redistribute pressure, accommodate certain structural differences, or influence how forces move through the foot during standing, walking, and running.
The word orthotics covers several different products. A soft cushioning insert purchased at a store is not the same as a prescription device designed specifically for a child’s feet.
Over-the-Counter Shoe Inserts
Prefabricated inserts are made in standard sizes rather than for one specific foot. Depending on the product, they may provide additional cushioning or general arch support and can be sufficient for some children with relatively simple needs.
Custom Orthotics for Children
Custom orthotics for children are prescribed based on an individual evaluation and designed around the child’s foot structure, symptoms, biomechanics, and treatment goals. The design can vary depending on what the device is intended to accomplish.
The most expensive or most customized option is not automatically the best option. The goal is to determine whether an orthotic is appropriate in the first place and, if so, what type of support makes sense for that particular child.
Signs Your Child May Benefit From a Foot Evaluation
Foot shape alone does not determine whether a child needs orthotics. Symptoms and function are often more useful clues.
Recurring Foot or Ankle Pain
Children should not routinely have to stop normal activities because their feet hurt. Repeated arch, heel, ankle, or other foot pain deserves evaluation, particularly when symptoms consistently occur during walking, running, or sports.
Foot Fatigue During Activity
A child who regularly complains that their feet feel tired, sore, or uncomfortable much sooner than expected may have a foot or gait issue worth evaluating.
Painful Flat Feet
Flat feet are common during childhood and often cause no problems. When low arches are accompanied by pain, stiffness, pressure areas, limited motion, or difficulty with activities, further evaluation may be appropriate.
Recurring Sports-Related Symptoms
Running and jumping place repeated forces through growing feet. If a child repeatedly develops foot discomfort during sports, the podiatrist can assess whether footwear, training, an injury, foot mechanics, or another factor may be contributing.
Unusual Shoe Wear or Pressure Areas
Markedly uneven wear, repeated blisters, calluses, or areas where the shoe consistently rubs can provide useful clues about how pressure is being distributed across the child’s foot.
Changes in Walking or Activity
Limping, avoiding activities, difficulty keeping up with peers, or a noticeable change in the way a child walks warrants attention. Orthotics may or may not be part of treatment depending on the underlying cause.
Important: Not Every Child With Flat Feet Needs Orthotics
A child’s foot can look flat and still be healthy, flexible, comfortable, and fully functional.
Flat feet are particularly common in young children because their feet are still developing. A visible arch often becomes more apparent as children grow. If a child has flexible flat feet without pain, stiffness, or functional limitations, treatment may not be necessary.
Orthotics should not be prescribed simply to make a normal, painless child’s arch look higher. Shoe inserts do not create an arch or guarantee that a child’s foot will develop differently.
When flat feet are painful, stiff, asymmetric, progressively changing, or interfering with activity, however, evaluation can help determine whether treatment is appropriate.
Pediatric Flat Feet
When Might Orthotics Help a Child With Flat Feet?
The distinction between painless flat feet and symptomatic flat feet is important.
When a child with flat feet experiences discomfort or functional problems, orthotics may sometimes be used to support the foot, redistribute pressure, or reduce mechanical strain. They may be combined with footwear recommendations, activity modification, stretching, physical therapy, or other treatments depending on the cause of the symptoms.
Children with stiff or rigid flat feet require a different evaluation because the loss of arch may occasionally be associated with an underlying structural condition.
Learn more about pediatric flat feet and treatment options.
What Problems Can Pediatric Orthotics Be Used For?
Orthotics for kids may be considered as part of treatment for selected foot and ankle problems. Whether they are appropriate depends on the diagnosis rather than simply how a child’s feet look.
Symptomatic Flexible Flat Feet
Orthotic support may help some children with flexible flat feet when the condition is associated with foot fatigue, discomfort, or other symptoms.
Abnormal Pressure or Friction
An orthotic may sometimes be designed to redistribute pressure away from areas that repeatedly become irritated during standing or activity.
Selected Sports-Related Problems
When foot mechanics contribute to a child’s symptoms, an orthotic may sometimes be incorporated into a broader sports injury treatment or prevention strategy.
Certain Foot Alignment or Structural Concerns
Some children have structural differences that change how pressure moves through the foot. Orthotics can sometimes provide support or accommodation depending on the diagnosis.
Heel or Arch Symptoms
Some causes of pediatric heel or arch discomfort may benefit from additional shoe support, although the correct treatment depends on what is actually causing the pain.
Other Biomechanical Foot Problems
Because children’s feet and gait patterns vary, a podiatric evaluation is important before assuming that an insert will correct a particular walking or alignment concern.
What Children’s Orthotics Cannot Do
Parents understandably want to address a potential foot problem early, but children’s orthotics are sometimes given more credit than they deserve. Understanding their limitations is just as important as understanding their potential benefits.
Orthotics Do Not Create an Arch
Putting an insert under a child’s foot can support the arch while the orthotic is being worn, but that does not mean the device will permanently create or develop an arch.
They Do Not Correct Every Gait Difference
Problems such as in-toeing and out-toeing can originate from different areas of the leg and hip as well as the foot. An insert cannot be assumed to correct a rotational difference without first identifying its cause.
They Are Not a Substitute for Diagnosis
Pain may come from bones, joints, tendons, ligaments, growth plates, nerves, skin, or an injury. An orthotic should not be used as a substitute for determining why a child is having symptoms.
Custom Orthotics vs. Store-Bought Inserts for Kids
One of the most common questions parents have is whether their child really needs a custom device or whether a store-bought insert will work.
Prefabricated Inserts
A quality over-the-counter insert may be reasonable for some children who need basic cushioning or support. These products are less individualized and are generally selected by shoe size.
Custom Pediatric Orthotics
Custom devices are prescribed for an individual child after evaluating their feet, symptoms, and biomechanics. They allow the design and support characteristics to be tailored more specifically to the treatment goal.
Custom does not automatically mean necessary. A podiatrist can help determine whether your child’s problem warrants a custom device, a prefabricated insert, a change in footwear, another treatment, or no treatment at all.
Can Orthotics Help Children Who Play Sports?
Young athletes place substantial repetitive loads on their feet and ankles. Running, jumping, cutting, and sudden changes in direction can expose problems that may not be noticeable during ordinary daily activity.
For some young athletes, foot mechanics may contribute to recurring discomfort or place excessive pressure on certain areas of the foot. When that is the case, pediatric orthotics may sometimes be used alongside appropriate footwear, rehabilitation, activity modification, strengthening, or other treatment.
However, an orthotic should not be used to simply mask an undiagnosed sports injury. Persistent heel pain, ankle pain, swelling, limping, or pain that affects performance should be evaluated.
Learn more about our sports-related foot and ankle injury care.
Pediatric Gait & Alignment
Can Orthotics Correct In-Toeing or Out-Toeing?
This is an important distinction for parents.
In-toeing and out-toeing describe the direction a child’s feet point while standing or walking, but the cause can come from different parts of the lower extremity. Some rotational differences originate higher in the leg rather than in the foot itself.
Because of that, shoe inserts should not be assumed to correct in-toeing or out-toeing. Many common childhood rotational variations improve naturally with growth and do not require corrective shoes or orthotics.
If a gait difference is severe, painful, asymmetric, worsening, associated with frequent tripping, or interfering with activity, a pediatric foot and gait evaluation can help determine its source.
Read more about in-toeing and out-toeing in children.
What Happens During a Pediatric Orthotics Evaluation?
Before recommending custom orthotics for a child, the first step is understanding the problem the device would be intended to address.
1. Symptoms & History
The podiatrist may ask when symptoms occur, what activities make them worse, whether there have been previous injuries, and whether similar foot patterns run in the family.
2. Foot & Ankle Examination
Foot shape, flexibility, joint motion, tenderness, strength, alignment, and other relevant findings can be assessed.
3. Gait Evaluation
When appropriate, observing how the child stands and walks can provide additional information about foot mechanics and lower-extremity alignment.
4. Footwear Review
Shoe fit, support, wear patterns, and the demands of the child’s activities or sports may also be considered.
5. Additional Testing When Needed
Many pediatric foot concerns can be evaluated clinically. X-rays or other testing may be recommended when symptoms, stiffness, injury, or structural findings warrant additional investigation.
6. Individual Treatment Plan
If treatment is appropriate, recommendations may include observation, footwear changes, exercises, physical therapy, orthotics, activity modifications, or another approach based on the diagnosis.
Do Children’s Feet Outgrow Custom Orthotics?
Children grow, and their feet grow with them. A device that fits properly today will not necessarily continue fitting indefinitely.
If your child wears custom orthotics, their feet, shoes, symptoms, and devices should be reassessed periodically. How often replacement is necessary depends on growth, wear, the orthotic design, and whether the child’s treatment needs have changed.
Parents should also pay attention to signs that an orthotic may no longer fit properly, including new pressure areas, discomfort, difficulty fitting the device into appropriately sized shoes, or a noticeable growth spurt.
Does My Child Have to Wear Orthotics Forever?
Not necessarily. The duration of orthotic use depends on why the device was prescribed and how the child’s symptoms and feet change over time. Some children may use orthotics during a particular stage of growth or activity, while others with ongoing structural or biomechanical needs may benefit from longer-term support.
The decision should be reassessed as the child grows rather than assuming that a prescription made years earlier will always remain necessary.
What Shoes Should Children Wear With Orthotics?
The orthotic and the shoe work together. Even a well-designed device may be uncomfortable or ineffective if the shoe does not fit properly.
Depending on the child’s needs, useful footwear characteristics may include:
- Enough length and width for the child’s foot without crowding the toes
- A secure fit around the heel
- Enough internal depth to accommodate the orthotic comfortably
- A removable factory insole when additional space is needed
- A secure closure such as laces or hook-and-loop straps
- A shoe appropriate for the child’s activities
Because children’s feet grow quickly, shoe size should be checked regularly. Shoes should not require a painful “break-in” period.
The Bottom Line for Parents
How Do I Know If My Child Really Needs Custom Orthotics?
You generally cannot determine the need for custom orthotics based only on how a child’s arch looks.
A more useful question is whether your child has pain, fatigue, recurring symptoms, abnormal pressure, stiffness, activity limitations, or another diagnosed foot problem that could benefit from additional support.
If your child runs, plays, and participates comfortably and simply has low arches, orthotics may not be necessary. If something is painful, changing, or limiting what they can do, an evaluation can help determine why.
Pediatric Podiatry in Metro Detroit
Children’s Orthotics in Livonia & Royal Oak, MI
If your child has recurring foot pain, painful flat feet, sports-related symptoms, or another foot or gait concern, Nationwide Foot & Ankle Care, P.C. can evaluate the problem and help determine whether orthotics are appropriate.
Our approach begins with identifying the reason for your child’s symptoms rather than assuming every child needs an insert. Depending on the evaluation, recommendations may include monitoring, footwear changes, exercises, physical therapy, an over-the-counter insert, custom orthotics, or another treatment.
Nationwide Foot & Ankle Care provides pediatric foot and ankle care at offices in Livonia and Royal Oak, Michigan, serving families throughout Metro Detroit and surrounding Southeast Michigan communities.
Frequently Asked Questions About Children’s Orthotics
How do I know if my child needs orthotics?
A child may benefit from evaluation if they have recurring foot or ankle pain, painful flat feet, unusual pressure areas, foot fatigue, recurring activity-related symptoms, or another foot problem. The appearance of a child’s arch alone does not determine whether orthotics are necessary.
Do all children with flat feet need orthotics?
No. Flexible flat feet are common in children, and painless flat feet often do not require treatment. Evaluation is more important when flat feet are painful, stiff, asymmetric, changing, or interfering with activity.
Will orthotics create an arch in my child’s feet?
Orthotics can support a child’s foot while they are being worn, but they should not be expected to permanently create an arch or change normal arch development.
Are custom orthotics better than store-bought inserts for kids?
Not necessarily. Prefabricated inserts may provide sufficient cushioning or support for some children. Custom orthotics allow a device to be designed around an individual child’s foot and treatment needs when greater customization is appropriate.
Can children’s orthotics help with foot pain?
They may help selected types of foot pain when mechanics or pressure contribute to symptoms. Because children’s foot pain has many possible causes, the underlying problem should be evaluated before assuming an orthotic is the correct treatment.
Can orthotics fix in-toeing or out-toeing?
Not necessarily. In-toeing and out-toeing can originate from different parts of the foot, leg, or hip, and many childhood rotational variations improve naturally. An evaluation can help determine the cause and whether treatment is necessary.
Can kids wear orthotics while playing sports?
Some children use orthotics in athletic footwear when they are part of a treatment plan. The device and shoe should fit appropriately, and sports-related pain should be evaluated rather than simply covered up with an insert.
Will my child outgrow custom orthotics?
Children’s feet grow, so orthotics should be reassessed periodically. Replacement depends on growth, wear, fit, the type of device, and whether the child’s treatment needs have changed.
How long does a child need to wear orthotics?
There is no single timeline. Duration depends on why the orthotics were prescribed, the child’s symptoms, growth, activity level, and how their foot mechanics change over time.
What shoes work best with children’s orthotics?
The shoe should fit the child’s foot properly and have enough room to accommodate the orthotic without crowding the foot. A secure heel, appropriate width and depth, and removable factory insole can be helpful depending on the device.
At what age can a child get custom orthotics?
There is no universal age at which every child should receive orthotics. The decision is based on the child’s condition, symptoms, development, and treatment needs rather than age alone.
Where can I have my child evaluated for orthotics in Metro Detroit?
Nationwide Foot & Ankle Care, P.C. provides pediatric foot and ankle evaluations at its Livonia and Royal Oak, Michigan offices. Parents can request an appointment online to discuss foot pain, flat feet, gait concerns, sports-related symptoms, and whether orthotics may be appropriate.
Concerned About Your Child’s Feet?
If your child has foot pain, painful flat feet, activity-related symptoms, or another foot or gait concern, schedule an evaluation at Nationwide Foot & Ankle Care in Livonia or Royal Oak.