Pediatric
Flatfoot
Custom-built for children 5–16 with arch collapse — maximum midfoot control during critical foot development, congruent to every patient's foot model.
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Pediatric flatfoot begins in development, not at the arch.
Every step a child takes shapes the structure of their growing foot. When the arch fails to develop — or collapses entirely — the consequences extend far beyond the foot itself. Left uncorrected, abnormal mechanics at this stage can cause ankle, knee, hip, and back problems that persist into adulthood.
The window for intervention is critical. Children's feet are flexible and responsive — which means the right orthotic at the right time can redirect development before structural changes become permanent.
Arch collapse under load
Partial or complete collapse of the medial longitudinal arch increases pronation and shifts load onto structures not designed to carry it.
Hyperpronation in gait
Children's foot flexibility often amplifies hyperpronation — increasing transverse movement in the midfoot with every step.
Chain-reaction compensation
Uncorrected flatfoot alters gait mechanics upward — contributing to knee valgus, hip instability, and lower back strain over time.
The P10 corrects development, not just discomfort.
Custom-fabricated with lateral and medial flanges to provide maximum transverse midfoot control — built to the child's exact foot shape.
Three interventions.
One precise solution.
The P10 doesn't just support the arch — it addresses the biomechanical drivers of pediatric flatfoot at every stage of gait.
Lateral & medial flanges
Extended flanges provide maximum control of transverse movement in the midfoot — essential given the flexibility of children's feet and the degree of hyperpronation often present.
Deep heel cup with EVA post
A 12mm heel cup pressed directly from the patient's calcaneus stabilizes the rearfoot — controlling the specific degree of pronation present in each child's gait, not an average.
Congruent polypropylene shell
Fabricated from a positive model of the patient's foot, the rigid frame distributes load correctly and provides continuous neurological feedback to retrain muscle firing sequences during development.
It's not just support. It's how muscles develop.
The shape beneath a child's foot determines how hundreds of muscles sequence during every step. A correctly congruent orthotic doesn't just support — it actively retrains neuromuscular patterns during the most formative years of musculoskeletal development.
- Proprioceptive feedback — congruent contact with the plantar surface provides continuous input, improving intrinsic muscle activation quality throughout gait.
- Transverse midfoot control — lateral and medial flanges limit side-to-side movement, reducing compensatory loading on the ankle and knee during each step.
- Rearfoot stabilization — the deep heel cup controls calcaneal inversion and eversion, establishing a stable base for the entire kinetic chain above.
- Load redistribution — volume congruency distributes plantar pressure across the correct structures, reducing sharp localized loading that perpetuates symptoms and changes in gait.
Shape is everything.
What separates Root from generic pediatric insoles is the precise morphological shape captured from the child's foot — held in the exact clinical position the clinician chose. No averaging. No guesswork.
The P10 is built from a positive model of the patient's foot and can be modified at the practitioner's discretion. This means every device fits the child it was made for — not an approximation of that age group.
Modern Root
Width adjusted considering both borders. Default for all Root models.
Traditional Root
Justified to the lateral border. Used for specific clinical indications at practitioner discretion.
Modern Root shape process
- Forefoot balanced to rearfoot — forefoot-to-rearfoot relationship is optimised as the first step in shape modification.
- Fat pad expanded ~3mm — ensures the device fills the calcaneal contour precisely for the child's heel.
- Arch lowered ~3mm — creates optimal heel-to-arch-to-met-head geometry. Not applied to foam impressions.
- Width tuned to both borders — medial and lateral widths considered together, giving a foundation that matches the child's actual foot width.
*Subtalar joint neutral is found by palpating the talus head against the navicular. In pediatric patients, neutral position and joint relationships vary significantly with age and developmental stage. Biomechanical evaluation required.
How you hold the foot is what we build.
Root is not just the orthotic — it's the clinician's positioning, captured and preserved in the device. After scanning a pediatric patient, FootID Pro asks the questions no other lab asks.
After every scan, we need to know:
- Was the subtalar joint held in neutral?
- Was the midtarsal joint maximally pronated — loading the 5th metatarsal head?
- Was the midtarsal joint maximally supinated — loading the 1st metatarsal head?
- Was the forefoot brought perpendicular to the rearfoot?
- Was a forefoot-to-rearfoot balance bisection achieved at 90° relative to the calcaneal bisection?
The positioning of those 19 joints in the foot is what gives us the shape — and in a growing child, precision here is not optional.
CAD/CAM fabrication
- Scan or cast captured — clinician captures foot morphology via FootID Pro, holding the subtalar joint in the chosen clinical position.
- Shape modification applied — forefoot balanced to rearfoot, fat pad expanded, arch adjusted using Root's design process.
- Technical staff review — every P10 reviewed against prescription. Flanges, heel cup depth, and cover selection confirmed per patient.
- Fabricated to the shape — the polypropylene frame and EVA post are fabricated to match the submitted shape precisely.
See how the scan becomes an order.
Watch Kevin capture a foot, confirm the clinical position, and send a Root order — start to finish.
Variation converted to anatomy-match accuracy by impression & fabrication method
How closely each method preserves the patient’s intended foot shape. Scale: 0–100%, where 100% = optimal congruence.
Plaster bandage is wrapped around the foot in the clinician’s prescribed corrected position, setting into a precise negative of the foot’s contour.
The foot is pressed into a crushable foam box, leaving a negative impression of the plantar surface.
An existing positive model from the patient’s previous orthotics is reused — KevinRoot accepts models from any lab, with frame-contour variance as low as 1%.
A digital scanner such as FootID Pro captures the foot surface as a 3D model.
A fiberglass casting sock is applied over the foot and cures to capture its contour.
Pedobarography captures the patient’s plantar pressure distribution (static or dynamic) at 1:1 scale — used with arch height and shoe size to select a redimold positive model, not to capture true 3D contour.
A direct-molding system using prefabricated, size- and arch-based positive models (33 in total) rather than an individual foot impression.
Heated material is vacuum-pressed over a plaster positive model, drawing it intimately into every contour.
The frame is 3D printed by selective laser sintering (SLS) directly from the CAD-designed digital frame.
A positive model is CNC-milled (CAD/CAM) from an STS, 3D scan, plaster, or foam impression, then the frame is vacuum formed over it.
A CNC machine subtractively mills the frame from a block of polypropylene or EVA per the digital design.
*Redimold has no physical or digital foot impression — patient-foot-to-cast congruent accuracy is unavailable. Variation from positive model to frame is low.
How your patient's foot shape becomes a precision frame.
The journey from clinical capture to finished P10 frame is where Root's expertise lives. Every step preserves the shape and position the clinician chose for that child.
- Foot impression captured — the clinician captures the foot using their preferred method. How the foot is held directly determines the congruency of the finished device.
- Positive model created — the impression becomes a physical plaster model or a digital CAD/CAM model. Digital models are stored indefinitely — useful as the child's foot grows.
- Root technicians modify the shape — every modification reviewed against the prescription. Flange position, heel cup depth, and cover selection confirmed per patient.
- P10 frame fabricated — the polypropylene shell is vacuum formed over the positive model. Vinyl top and bottom covers are applied. Flanges are finished to specification.
FitFoot360 Foot Model
- Root digital model stored indefinitely → recalled for future pairs as the child grows
- Root technicians modify the digital shape in real-time: arch, heel, width, flanges, postings
- Vacuum formed over CAD/CAM positive model — replicable, consistent, precise
Real-time control over shape, function, and fit.
FitFoot360 gives Root's technicians complete digital control over every dimension of the P10 frame — in real time. Every modification is precise, repeatable, and stored permanently — so as your patient grows, their history and shape are always on file.
Digital positive model — stored for growth
Future pairs as the child grows can be fabricated from the same baseline shape, with adjustments. A new impression isn't always required.
Real-time shape modification
Root technicians control arch, heel, width, flange depth, and postings directly in the software — every parameter visible and adjustable.
Every parameter per patient
Heel cup depth, frame reinforcement, lateral and medial flange placement, and vinyl cover selection are all set per child — never per template.
Plaster and foam digitisation
Physical models can be digitised for permanent storage. Note: digitising may not perfectly replicate the intimate contours achieved when vacuum forming directly over plaster.
Built to their spec. Built for their foot.
Every parameter of the P10 is set to the individual patient — material rigidity, rearfoot posting, heel cup depth, and covers are all chosen for that child's anatomy, weight, and gait demands.
Rigidity is selected per patient weight — so the shell provides exactly the control that child's gait requires, without over-bracing or under-supporting.
The crepe extrinsic rearfoot post is congruent to the patient's foot — providing rearfoot stability without a generic wedge that shifts load unpredictably.
Cast directly from the patient's calcaneus, the heel cup fits their heel precisely — controlling their specific degree of inversion and eversion, not an average for their age group.
Vinyl top cover withstands perspiration from active pediatric patients, trimmed to the child's metatarsal head line for precise pressure distribution.
Vinyl bottom cover protects the polypropylene shell and withstands the demands of daily use in growing patients across multiple shoe environments.
Metatarsal extension ensures smooth forefoot contact and controlled push-off — finishing the device to the child's metatarsal head geometry.
What changes when development is corrected.
Correcting pediatric flatfoot biomechanically during the developmental window creates improvements that compound over time — preventing the cascade of problems that follow uncorrected arch collapse into adulthood.
- Reduced hyperpronation — lateral and medial flanges limit transverse midfoot movement, reducing pronation strain at every step.
- Improved gait pattern — corrected rearfoot alignment retrains the neuromuscular firing sequences that govern gait during development.
- Full kinetic chain stabilization — a corrected foot position reduces compensatory strain in the ankle, knee, hip, and lumbar spine.
- Prevention of future pathology — structural correction at ages 5–16 significantly reduces the risk of adult foot, knee, and back conditions linked to untreated flatfoot.
Designed to take strain off the developing foot.
The P10 incorporates lateral and medial flanges to provide maximum control of transverse movement in the midfoot — essential in pediatric patients where foot flexibility and hyperpronation combine to drive arch collapse. It's pressed with a crepe extrinsic rearfoot post and polypropylene frame, and covered with a vinyl top and bottom cover designed to withstand perspiration from active children.
Because children's feet are responsive to mechanical input during development, early orthotic intervention with the P10 can redirect the trajectory of arch development — reducing the need for more aggressive intervention later.
The full picture.
Everything you need to prescribe the P10.
- Congenital deformities
- Pes planus (flatfoot)
- Ehlers-Danlos syndrome
- Partial arch collapse
- Complete arch collapse
Recommended for
- Pediatric patients (ages 5–16) requiring rigid control
- Hyperpronation in growing patients
- Developmental flatfoot needing early intervention
Designed for patients ages 5 to 16 with flatfoot — a common condition during a child's developmental years. Symptoms include pain, a change in gait, or discomfort while walking.
Because of the flexibility of children's feet and often-present hyperpronation, this device incorporates lateral and medial flanges to provide maximum control of transverse movement in the midfoot. Fits in most shoes with removable sock liners or insoles.
Custom congruent to patient using: Plaster, Foam, STS, 3D Scanner, Pedobarography, Existing Positive Model, Redimold.
- L3000 (UCB)
- L3010 (longitudinal/metatarsal support)
- L3020 (arch support)
- L5000 (filler)
Based on configuration. Final coding and billing are the provider's responsibility.
Delivery Time
- Standard: 2 weeks
- Expedited: Available on request
Pediatric Flatfoot
Flatfoot — or pes planus — is one of the most common conditions presenting in pediatric patients. It occurs when the medial longitudinal arch partially or completely collapses under load, altering the mechanics of every step the child takes.
A Developmental Window That Closes
Some degree of flatfoot is normal in infants and young toddlers. As the foot develops, the arch typically forms between ages 3 and 10. When it fails to form — or collapses rather than develops — the resulting biomechanical alteration is not simply cosmetic. It changes how the child stands, walks, and runs, and how load is distributed through every joint above the foot.
Symptoms may include pain, a change in gait, or discomfort while walking. Parents often notice the child tires more quickly, avoids physical activity, or complains of foot, ankle, or knee pain. Taking corrective measures at this stage of development may prevent future ankle, knee, hip, or back problems.
Causes and Contributing Factors
Congenital deformities — some children are born with structural differences that prevent normal arch formation. Early orthotic intervention is critical in these cases to guide development.
Hyperlaxity and connective tissue conditions — conditions such as Ehlers-Danlos syndrome increase ligament laxity, allowing the arch to collapse under load even when bone structure is intact.
Hyperpronation — excessive inward rolling of the foot during gait is both a cause and a consequence of flatfoot, creating a cycle of increasing arch collapse if not addressed.
Diagnosis
Clinical assessment includes observation of the arch in weight-bearing and non-weight-bearing positions, gait analysis, and palpation of the subtalar joint. X-ray may be used to assess bony alignment. A Jack's test (great toe extension) can help distinguish flexible from rigid flatfoot — an important distinction in treatment planning.
Treatment Pathway
For flexible pediatric flatfoot, custom orthotics are the first-line structural intervention. Stretching of the Achilles tendon and calf musculature is frequently prescribed alongside orthotic therapy. Activity modification may be indicated for symptomatic presentations. Surgical intervention is reserved for rigid flatfoot or cases that fail to respond to conservative management over an extended period.
The P10 is designed to be part of the first-line response — providing maximum control of transverse midfoot movement from the first step, supporting normal arch development while the foot grows.
Order on FootID Pro →The right device
for the right diagnosis.
P10 is indicated for a range of pediatric foot conditions during the developmental window.
Prescribe with confidence across these presentations.
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