Flatfoot may be classified as pathologic or physiologic. Pathologic flatfoot is often characterized by stiffness of the foot, causes disability, and requires treatment. Physiologic flatfoot is a normal variation; it causes no disability and tends to improve with time. Physiologic flatfoot is most common in individuals who are loose-jointed, are obese, or usually wore shoes during childhood. Treatment of children with physiologic flatfoot with orthoses or shoe modifications not only is ineffective but is uncomfortable and embarrassing for the child and is associated with lowered self-esteem in adult life.

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