Pediatric

Pediatric Flat Foot

Let’s talk about pediatric flat foot. Many children appear to have flat feet. That’s because the fat tissue underneath there arch is pressed to the ground when walking.

It’s really important to differentiate what is normal physical development versus what is pathological. Some signs to watch out for that you might want to notice in your children are:

a medial talar (bone) bulge right along the inside of the ankle
a flattened lowered arch or a collapsed arch
an eversion, or rolling in of the heel
most importantly a navicular drop, or a drop in the bone on the inside of your arch.

Custom foot Orthotics with a medial flange can help support the arch and place the foot into a neutral position thereby allowing a very steady controlled gait.

If you notice any of these symptoms in your children please give us a call so we can do a consultation for you. Call Burlington Orthotic Centre today at 905-331-4391 for details.

Childhood Developmental Stages

How does a child learn to walk? This is a skill we don’t need to teach; it will happen naturally and occurs in very distinct stages. Parents eagerly await those first few steps and often try to rush the process. However, it will take place once the neurological and musculoskeletal systems are mature and cohesive.

A child will begin to stand and cruise along furniture just before one year of age. However, walking independently can happen anywhere between 10-18 months. At this point they have a very wide stance and take many quick steps to maintain their balance. They also walk with their arms held up to protect during falls.

Within 6 months of beginning to walk the child will have developed a more natural walking pattern with their arms down and swinging. They also strike the ground with their heel first as oppose to the entire foot flat at once. However, their feet remain wider apart to help with balance.

As their neurological and musculoskeletal systems continue to develop and make connections they acquire skills such as running, walking on tippy toes, using stairs and standing on one leg. By 8 years old children have developed the gait and posture nearly identical to an adult.

Watching our children develop new skills is one of the joys of being a parent. These skills are inherent and will come with time but cannot be rushed. It is important to make sure your child is hitting the correct milestones but be careful not to wish this precious time away too quickly!

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Pediatric Flatfoot

Pediatric flatfoot is one of the most debated conditions when it comes to deciding whether treatment is necessary or beneficial to avoid. It is not uncommon for doctors to disagree on when to avoid or prescribe treatment, which can be confusing for the parent. What we do know is that children are almost universally flatfooted when they start walking due to a large fat pad underneath their arch. However, as children begin to grow this fat pad decreases and some of the arch structure becomes apparent. At this stage there are two different styles of flatfoot with one being flexible and the other being rigid. Flexible flatfoot can further be divided in to symptomatic (with pain) and asymptomatic (without pain) flexible flatfoot. At this stage, generally in the age range of 5-8, a Pedorthic assessment can help establish which style of pediatric flatfoot your child presents with.

Tip Toe Walking

photo credit: FotoGrazio Family of 3 via photopin (license)

As a child I can recall walking down the street with my mom, my older brother a few meters ahead of us. As we walked my mom instructed “heel, toe, heel, toe”. She was concerned because although he was nearing his teen years my brother was still a frequent tiptoe walker. This was a practice he’d retained from childhood and I was starting to model his behaviour.

Tip Toe walking is commonplace until approximately the age of three years old. After such time a normal heel to toe gait pattern typically emerges. Toe walking that continues past this age can lead to tight Achilles tendons, which perpetuates the toe walking. Young children can also be distracted while walking and, in addition to tripping and veering; toe walking can be a hazard of this behaviour. However, it can also be a symptom of a more serious condition such as cerebral palsy and muscular dystrophy. Typically these cases also present with additional symptoms and milestone delays. If there is ever a concern about a more serious cause seek the advice of your pediatrician or family physician.

It is important for parents to outfit children in supportive footwear that fits correctly and sometimes a helpful “heel, toe” reminder can aid their normal gait development. If you are concerned about your child’s toe walking ask one of our Canadian Certified Pedorthist for their guidance.

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Does Your Child In Toe?

Childhood developmental milestones are a huge concern for parents. Everyone wants to make sure their little one is hitting the landmarks they should be. Crawling, walking, and running; these are all things we assess to ensure our child is where they should be. So it comes as no surprise that when something appears amiss we are quick to look for confirmation of normalcy.

As Certified Pedorthists we assess gait patterns in people of all ages and young children are no exception. One of the most common reasons for a pediatric assessment is worry regarding in-toeing. It is important to remember that in-toeing is very common in young children due to the structural position of their hips and legs at a young age. In the majority of children these structural positions resolve by eight years old.

It is possible to aid in correcting childhood in-toe. A specialized orthotic called a “gait plate” is used to gently guide the child toward a more straight foot position. In addition it is important to use well-structured footwear, verbally encourage pointing the toes forward with walking and reinforce sitting with legs crossed in front of them. The commonly seen “W” position, when sitting can encourage the continued internal rotation that perpetuates in-toeing.