First off, do not panic. Children are developing beings. For the most part, common “foot abnormalities” in children spontaneously resolve as development progresses. At birth, a baby’s foot is made up of mostly cartilage, which hardens or ossifies to actual bones with age. Until a child’s foot develops adult bones, it will be very soft and flexible. As infants mature and learn to walk, their bodies undergo a process known as developmental unwinding where their limbs will unfold and externally rotate. In fact, the hips can unwind even up until age fourteen.
With that being said, it is important to be attentive to your child and what they may be trying to tell you as well as knowing when certain behaviours or tendencies do not follow the correct linear pattern of development. If your child is complaining of pain, “tired feet”, or is overly clumsy and/or frequently tripping, it is important to talk to your child’s paediatrician for further investigation. Your child’s paediatrician may then recommend a visit to a foot care specialist for proper podiatric management to prevent progression of symptoms into adulthood.
Here is a list of common foot problems seen in children.
Flat feet are part of normal development in children up until the age of six. If your child has a mild and flexible flat foot and is under the age of 6, there is a good chance he or she may grow out of it. However, if your child is severely flat-footed, is developing pressure points, and is experiencing symptoms (this includes not wanting to participate in activities or sports because of foot pain or discomfort), it is a good idea to seek professional advice. Your child may be recommended custom made orthotics or over the counter arch supports.
In-toeing, commonly known as pigeon-toed is said to be the most common reason why parents seek podiatric care for their child. It is when the toes point inward toward the midline of the body rather than straight forward with walking. In-toeing is usually related to the developmental unwinding process and can be attributed to abnormalities at various levels of the lower limb such as the hip, femur, tibia, foot itself. More often than not, in-toeing spontaneously resolves without causing long term issues. However, treatment is warranted if the child is complaining of symptoms such as pain, difficulty walking, or exemplifying over-pronatory compensations that may cause future complications. Talk to your chiropodist regarding gait plates and whether your child is a good candidate for them.
Toe walking is a normal occurrence in children as they learn how to walk, up until the age of three. Most children who continue to toe walk after the age of three and are otherwise developing normally, do so out of habit. Other causes include a congenital short Achille’s tendon, or other disorders such as, cerebral palsy, autism, and muscular dystrophy. In any case, talk to your child’s paediatrician regarding toe walking past the age of two. If your child is doing this habitually, it is important to establish heel to toe gait with the help of routine stretching and recommended footwear.
Sever’s disease is an inflammation of the growth plate in the heel bone. It is the most common cause of heel pain in growing children and young athletes between the ages of seven and twelve and is associated with growth spurts and increased activity levels. Rest assured, this condition is very common and self-limiting once the growth plate ossifies. Management lies in mitigating pain via rest from strenuous activities, daily stretches, and a biomechanical assessment to determine if faulty foot mechanics may be contributing to the problem.
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If you have been recommended by your child’s paediatrician to have your child’s feet assessed by a foot specialist, we’ve got you covered. Call us even to ask about a quick question and we’d be happy to point you in the right direction!
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