A lot of parents around the Worcester, MA area have come in and their children have flat feet or they have painful tendons from the tendons pulling up too hard on the arch of the foot. This is a common problem, especially during the sports season when they are doing more activity or wearing unsupportive flip-flops. If this happens to your child and their foot is painful from doing activity, you may want to consider orthotics. What I usually see is that children, when they are walking normally, they are fine in any type of shoe that they wear. But as they start to increase the rate of their activity they have more pain and they need more support. You can try a good sneaker. I usually recommend patients to go to Sneakerama to find those sneakers, and then you can try an over-the-counter insert in the sneaker. But sometimes these over-the-counter inserts may be too large for a child’s foot. There are two different types of orthotics that you can try. One of the orthotics is an over-the-counter type that is based on their foot size and it increases over time and it costs about $100. This is good for a normal foot. However, this week I had a patient that had a very wide foot and we needed to get them a custom orthotic. The price is a little bit higher, around $500, but the nice thing about the custom orthotics is that you can get a pediatric outgrowth program. What that means is that just for a little bit more you can have a guarantee that within two years you can get a second pair for no cost for the orthotic (but just a office scanning fee). If your child wears orthotics and goes through a pair in two years you can get another pair, so one pair will last you for about four years. So that is a good option as well. Just so you understand, for children orthotics are needed if they have pain and fatigue when they are walking, when they are standing, and when are playing different types of activities. Foot pain is normal for a child and usually it is because they have flat feet or their tendons are pulling hard on their growth plates which also can be helped with physical therapy or some type of an orthotic device.