Flat feet in children: Do insoles help or do they hinder? And how do walking barefoot and barefoot shoes strengthen the feet?

As a parent, it is natural that you want the best for your child. If someone told you that your child has flat feet and should wear orthopedic insoles or rigid shoes – you are not alone.

Many moms and dads get scared when they hear such a recommendation, especially if it comes from a doctor. But let's clarify together whether this is really necessary and what modern science says.

🦶 What are flat feet and when are they actually a problem?

Flat feet mean that the inner arch of the foot is not visible when the child is standing. But what most people don't know is that this is completely normal in young children.

The feet look flat because they are full of fatty tissue, and the muscles are not yet developed. As the child grows, moves, and plays, the arch naturally forms – usually by age 6 or 7, and for some children even later.

Therefore, if your child has no pain, does not trip often, and is developing normally, there is no need to worry. In most cases, the child simply needs more play, movement, and – to be barefoot as often as possible.

There are two types of flat feet:

• Flexible flat feet – the arch appears when the child stands on tiptoes. This is the most common type and DOES NOT require any treatment.

• Rigid flat feet – the arch does not exist even when the child is sitting or standing on tiptoes. In this case, you need to be referred to a specialist.

🏃 How do flat feet actually develop?

Today, children spend a lot of time in rigid, tight shoes, often with raised heels and hard soles.

Such shoes do not allow the foot muscles to work, and therefore they cannot develop as they should.

In addition, children spend less and less time outside, on uneven terrain, barefoot – and it is precisely this play on grass, sand, and earth that naturally stimulates the development of healthy feet.

👟 And what about insoles? Don’t they help?

If your child is already wearing insoles – don’t worry, you haven’t made a mistake. Most parents are advised to do this with the best intentions, often without enough information about alternatives.

This text is here to offer you another perspective, based on modern knowledge.

Of course, there are specific diagnoses and conditions (such as neuromuscular disorders or rigid deformities) where insoles and additional support may have their place, but for most children with flexible flat feet – they are not needed.

Despite popular belief, orthopedic insoles are not recommended for children who have flexible flat feet and no pain.

Insoles do the work instead of the muscles – and thus actually weaken the foot. In the long run, this can lead to the child developing a dependence on external support and never strengthening the natural arch.

Many international studies have shown the following (including studies from the journals The Foot and Journal of Pediatric Orthopaedics):

• Insoles do not accelerate the formation of the arch – natural development still occurs at the same pace, just without muscle activation. This is confirmed by a study published in the journal The Foot (2012), which states that there is no evidence that insoles affect arch development in children with flexible flat feet.

• Insoles can lead to compensations in gait – the body may develop unnatural movement patterns to adapt to the insole, which in the long term can affect posture and load distribution. This is the conclusion of a study published in the Journal of Pediatric Orthopaedics (1999), which means that the body starts making unnatural movements to adjust to the external support.

• Children without symptoms do not need any treatment – this is confirmed by numerous pediatric and orthopedic organizations, including Harvard Health.

📖 What does modern science and international recommendations say?

Numerous studies from the fields of orthopedics, pediatrics, and biomechanics agree on the following:

✅ If a child has flexible flat feet but has no pain and functions normally – no therapy is needed.

✅ Insoles do not correct the feet – they may possibly relieve pain in older children if there are symptoms, but they do not contribute to arch development. In some cases, they can even weaken the foot muscles, as they take over their function.

✅ Walking barefoot or in barefoot shoes allows for the natural development of the foot through muscle activation, stabilization, and proprioception.

These conclusions are confirmed by:

• A randomized controlled study from 2021, which showed that daily barefoot walking for 12 weeks significantly improves the arch in children aged 6–9 years (ResearchGate, 2021).

• Recommendations from the British National Health Service (NHS), which clearly state that flat feet are normal in children under 6 years old, that most children outgrow this condition without therapy, and that insoles and corrective shoes are rarely needed. They also state that barefoot walking at home and outdoors – when safe – is desirable.

• Nationwide Children's Hospital (USA), which recommends barefoot play on natural surfaces as the best way to strengthen feet. They state that insoles or special shoes are not needed if the child has no pain or difficulty walking.

• Staheli's study from 1987 which shows that children who often walk barefoot have fewer cases of flat feet compared to children who always wear shoes.

• Research by Hollander from 2017 published in the journal Gait & Posture, which confirms that barefoot walking contributes to strengthening the arch muscles and better motor control.

• An analysis published in the Journal of Foot and Ankle Research (2020) highlights that most experts agree that insoles are not necessary for children with flexible flat feet if there are no symptoms.

• Harvard Health, which emphasizes: “If the child has no symptoms, no treatment is needed.”

🔍 How can you check if everything is okay?

There are simple tests you can do at home:

👣 Wet test – Have the child wet their feet and step on paper or tiles. If the footprint is full and the arch is not visible, the foot is flat. If the arch appears when the child stands on tiptoes – everything is most likely fine.

🦶 Tiptoe test – If an arch appears when standing on tiptoes, it means the foot muscles are functional and the foot has the capacity to develop naturally.

In both cases – if the child has no pain, does not trip, and is actively playing – you can be at ease.

If you are looking for a natural solution – you already have it. It is walking barefoot. Numerous studies show that children who walk barefoot more often:

• Have fewer cases of flat feet

• Have stronger foot muscles and better motor skills

• Have better balance and proprioception (awareness of where the body is in space)

In situations where the child cannot be barefoot (e.g., outside or in kindergarten), barefoot footwear is an excellent alternative – it allows the foot to behave naturally, as if it were barefoot, but with protection.

🤔 So what should I do now?

If your child:

• Has no foot pain

• Runs, jumps, and plays normally

• Has no stiffness in the foot or serious deformities

...then they probably do not need any insoles, orthopedic shoes, or special intervention. Instead, encourage them to walk barefoot whenever possible, to climb, run on grass, and develop the muscles that will naturally form the arch.

Note: This text is for informational purposes and does not replace a professional examination. If you have doubts and the child shows symptoms, consult a pediatrician or orthopedic specialist.

Insoles and orthopedic interventions may be justified in special cases – such as rigid flat feet (which remain flat even when the child sits or stands on tiptoes), neuromuscular disorders, pain in the feet, knees, or back associated with the foot, gait disorders, frequent tripping, or delays in motor development.

📚 For moms and dads who want to know more

If you like to research, here are a few studies and articles that served as the basis for this text:

Harvard Health: https://www.health.harvard.edu/diseases-and-conditions/fallen-arch-a-to-z
Journal of Foot and Ankle Research (2020): https://jfootankleres.biomedcentral.com/articles/10.1186/1757-1146-6-22
Gait & Posture – Hollander et al. (2017): https://www.sciencedirect.com/science/article/abs/pii/S0966636217303733
Staheli et al. (1987): https://pubmed.ncbi.nlm.nih.gov/3560538/
The Foot (2012): https://www.sciencedirect.com/science/article/abs/pii/S0958259211001133
Journal of Pediatric Orthopaedics (1999): https://journals.lww.com/pedorthopaedics/Abstract/1999/03000/Do_foot_orthoses_alter_the_natural_history_of.4.aspx
NHS UK: https://elht.nhs.uk/services/orthotics/patient-information/what-parents-should-know-about-flatfeet-intoeing-bent-legs-and-shoes-children
Nationwide Children’s Hospital: https://www.nationwidechildrens.org/family-resources-education/700childrens/2016/05/flat-feet-why-kids-should-go-barefoot-this-summer
ResearchGate (2021): https://www.researchgate.net/publication/350066781_Effects_of_barefoot_walking_on_the_flat_foot_in_school_going_children_A_Randomised_control_trial
National Geographic: https://www.nationalgeographic.com/science/article/why-walking-barefoot-can-actually-help-your-feet

👣 Feet know their job. It is up to us to let them do it.