Paediatric foot problems can appear very early. They require attention, because the bones in a child’s foot are soft and pliable and easily damaged by constricting shoes, socks and even bedding. Shoes that fit are especially important for a young child’s rapidly growing feet. When choosing shoes for your child make sure the shoe shape matches the foot shape and the upper is firm in the heel area but is flexible around the front of the shoe. No one brand will suit all feet. The upper of the shoe should be made of leather or material, which will allow air to circulate around the foot. Don’t use hand-me-down shoes unless they are showing NO wear on the sole or upper.
Parents have to be on the alert for early developmental problems, since children do not usually complain about them. Check with your Podiatrist at the first sign of excessive toeing in or out, flat feet, walking or standing strangely, stumbling, or tiring easily. Help your children get off to a good start!
On our "walk through life," our feet undergo many changes. The most critical period is the first three years of life, when the feet are rapidly developing. While learning to walk, one-year-olds tend to turn their feet outward to widen their base for stability. By age three, however most children walk with their feet straight ahead.
If the unborn baby lies with its feet pressed against the womb the wrong way, it can be born with its feet, legs or hips turned inward. This may make learning to walk difficult and can result in the child toeing-in. The first sign of toeing-in may be difficulties with gross motor skills and tripping.
Other causes of toeing-in are abnormal sitting and sleeping positions. Frog or ‘W’ sitting, sitting on the feet and sleeping on the tummy can delay or stop the normal development of the leg, knee, thigh and hip. In the short term this may lead to toeing-in, night pains and gross motor problems. In the long term the child will probably turn the hip out to bring the feet into a more forward position but if the underlying problem is not corrected knee and foot pain may result.
If the inward twist is in the foot, treatment should begin as soon as possible and must be completed by the age of two. This may involve using plaster casts, night splints, day / night foot splints or exercises to change the foot shape.
If the twist is in the leg, knee, thigh or hip toeing-in can often be corrected through stretching or strengthening exercises. The Podiatrist can teach parents some simple exercises that can help. The exercises take minutes a day and they are performed until the problem is corrected. However if the twist in the limb is the result of an abnormal sitting or sleeping position, correction will not occur until the child stops these habits.
Toeing-out is more likely to be inherited than from an abnormal position in the womb. This is also unlikely to be the result of abnormal sitting positions but some children may twist their leg bone (tibia) out too far by ‘w’ sitting.
The problem is often an over-rotation in the hip or leg. Exercises sometimes help with the problem if treatment begins at an early age.
Many babies naturally appear flat-footed. Usually, this will disappear as the baby begins to stand and walk.
Children with flat feet, or low arches may not be able to keep up with other children because of the added strain on feet and legs.
There is no way of giving a child an arch if they have a true flat foot but may children who appear flat-footed have a normal arch but flatten it when they stand. This movement is called ‘pronation’ and may be cause a variety of painful symptoms, make the child tire easily or have problems with gross motor skills. If a child is pronating his/her feet orthotic devices may be useful to improve foot movement and relieve any painful symptoms.
Bow legs are normal at birth but should disappear by the time the child reaches two. If it does not disappear by the age of two then it may be permanent. The bowed appearance may be caused by a curve in the leg bone ‘tibia’ or may involve the entire limb. This curve may cause the foot to roll or may place extra strain on the knee joint.
The bow itself is not correctable but if pain occurs in the knees or feet orthoses may be useful to relieve any symptoms.
Knock-knees are normal in children aged from two to seven years. Some children may become knock kneed again around puberty. If the problem has persisted from the age of seven, it may be permanent. Like bow legs this leg position may cause the foot to roll or may place strain on the knee joint.
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|Arch Pain||Toe Fungas||Ball of Foot||Bunions|
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