Can Physical Therapy Help with Flat Feet in Children?

Some children walk, run, and play without a second thought—while others seem to tire easily or complain of foot pain. Could something as simple as flat feet be the hidden cause? And more importantly, can physical therapy make a real difference? Before you assume it’s just a phase they’ll outgrow, there’s something every parent should know…

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How Can Physical Therapy Improve Flat Feet in Children?

Physical therapy can be an effective way to treat flat feet in children using a non-invasive, personalized approach. A physical therapist creates a treatment plan based on the child’s condition and goals, incorporating therapeutic exercises, family education, and manual therapy.

Treatment may also include gait and balance training to correct patterns that put stress on the feet, as well as strengthening and stretching exercises to support the arch and improve flexibility. In some cases, orthotic devices such as braces or supportive footwear are recommended to relieve pressure and improve alignment. A therapist may also collaborate with specialists like orthotists or podiatrists to provide a more complete approach.

When physical therapy doesn’t lead to improvement, surgery might be considered in rare cases. Still, therapy plays a key role in recovery after surgery. It should begin within five days post-operation and include exercises to rebuild the arch, strengthen the foot muscles, and improve walking patterns.

With the right approach and professional guidance, physical therapy offers practical and effective ways to support children with flat feet.

Assessment of the Child’s Foot Structure and Gait

Evaluating foot structure and gait is a vital part of the therapy process for children with flat feet. It helps therapists identify each child’s specific characteristics, detect movement issues, and create a targeted treatment plan. The evaluation combines physical exams, clinical observation, and advanced tools for a detailed analysis.

Foot Structure Evaluation

Assessment begins with a visual exam of foot shape, heel position, and arch height. This helps detect any visible deformities or alignment concerns. Palpation follows, checking for sensitivity or irregularities in bones, joints, or soft tissue.

Range of motion is tested next by examining how the foot moves—such as dorsiflexion (lifting the foot), plantar flexion (pointing the foot), eversion (turning outward), and inversion (turning inward). Posture is also reviewed in both seated and standing positions to identify misalignments that might affect the foot.

Gait Evaluation

Gait analysis provides insight into how the feet move during walking. The therapist observes joint movement, coordination, and balance. Space-time parameters such as step length, phase timing, and walking speed are also measured.

Baropodometry may be used to study pressure distribution on the feet while walking, highlighting areas of high impact. High-definition video helps capture precise movement and reveal subtle gait irregularities that may be overlooked in real time.

This complete evaluation gives a clear picture of the child’s functional status and helps guide a customized therapy plan.

Strengthening the Foot and Ankle Muscles

Strengthening the muscles in the foot and ankle is key to managing flat feet in children. Specific exercises activate deep muscles, support the arch, and enhance balance. The following exercises are offered in seated and standing formats, adjusted to each child’s needs and abilities.

Seated Exercises

These are ideal for children with limited strength or mobility.

Toe and heel raises
While seated with knees at a 90° angle, the child lifts the toes while keeping the heels down, then switches. Repeat 10–12 times.

Edge balancing
Shift foot support between inner and outer edges, holding each for three seconds to engage side muscles.

Towel scrunches
Using the toes, the child tries to pull a towel placed on the floor toward themselves.

Toe squeeze with towel
Place a towel between the toes and squeeze tightly for 2–3 seconds. Do this 10 times per foot.

Toe spreading
The child spreads their toes apart and holds for one second with each repetition.

Arch activation
Gently lift the arch without lifting the heel or toes. Hold for five seconds.

Standing Exercises

These exercises are for children who are more active or further along in therapy.

Heel raises
Stand on tiptoes and hold for five seconds. Support may be used at first for stability.

Single-leg heel raises
Repeat the previous move on one foot to increase muscle effort and balance control.

Weight shifts
Shift body weight between the inner and outer edges of the feet, holding each for a few seconds.

Single-leg squats
Bend one knee slowly and return to standing, keeping proper alignment of the ankle and knee.

Small jumps
Start with gentle jumps using both feet, then progress to single-leg jumps as balance improves.

Active arch lifts
While standing, try to shorten the distance between the heel and the ball of the foot, raising the arch without lifting either.

Rest days between sessions are recommended, and walking barefoot for an hour daily can help strengthen the feet further, when done under supervision.

Stretching Tight Muscles and Tendons

Stretching helps improve flexibility, ease discomfort, and support better foot alignment when tight muscles and tendons limit movement.

Stretching Techniques

Stretches should always be done under a therapist’s supervision to ensure they’re safe and effective.

Improving Balance and Coordination

Physical therapy helps improve balance and coordination in children with flat feet using exercises that target muscle control, body awareness, and postural stability.

Therapy Approach

• Functional exercises: Include activities like standing on one foot, walking on uneven surfaces, or using light weights with coordinated movements.
• Proprioceptive training: Children practice sensing their body’s position with activities like walking on uneven terrain or closing their eyes while balancing.
• Professional guidance: All exercises are performed under the therapist’s supervision to ensure safety and success.

Therapy builds strength, balance, and stability in the feet. With regular sessions, children can improve how they move and experience less discomfort, setting them up for healthier movement patterns.

Educating on Footwear and Orthotics

Education on proper footwear and orthotic use plays a key role in therapy for flat feet in children. Choosing the right shoes—those with good cushioning and support—can help distribute pressure more evenly and reduce joint stress during daily activity.

Orthotics are external supports that help stabilize or correct joint movement. For flat feet, they may help lift the arch, improve alignment, and ease pain. These tools should match the child’s specific needs and be used under the guidance of a therapist, who will determine the type, purpose, and duration of use.

Combined with exercise, informed use of footwear and orthotics gives families practical ways to manage flat feet. This guidance improves treatment outcomes and helps children gain independence in daily movement. When used consistently, these tools can support long-term improvement and help avoid future complications.

Sources:

• Латогуз, С. І., & Ковальов, М. М. (2024). FEATURES OF PHYSICAL THERAPY FOR FLAT FEET IN YOUNG ATHLETES TREATING FLAT FEET IN YOUNG ATHLETES: A PHYSICAL THERAPY APPROACH. Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії, 24(1), 234-238.
• G’aniyev, S. (2025). TECHNOLOGIES FOR THE EFFECTIVE USE OF PHYSICAL EDUCATION TOOLS IN THE REHABILITATION OF CHILDREN WITH FLAT FEET. International Journal of Artificial Intelligence, 1(3), 585-587.