What does a Podiatrist do?
Podiatrists deal with the prevention, diagnosis, treatment and rehabilitation of medical and surgical conditions of the feet and lower limbs. Children’s feet differ from those of adults as they are not fully formed. With this in mind the podiatrist and physiotherapists. At Therapies for Kids are aware of the developmental milestones and patterns of growth of children’s feet and feel we need to provide a collaborative and innovative approach to the management of lower limb problems for children and adolescents. To provide this we have a regular clinic with both podiatry and physiotherapy input.
Conditions affecting bones, joints and the tissues around them are described as ‘musculo-skeletal’ or ‘orthopaedic’. Because there are many physiological and anatomical differences between children and adults, children require a specialised approach to their orthopaedic management. The physiotherapists at Therapies for Kids always consider these differences when assessing and treating children.
When children first start walking they will often walk on their toes or with their feet turned in. This is quite normal, but usually improves by the time they are 6 or 7. Sometimes, as children grow, they develop an uneven walking pattern which can be improved with physiotherapy.
Common Foot Problems in Children
Pronation (Flat Feet, Over Pronated Foot Type)
This very common condition and it refers to when the arch or instep of your foot is less curved or low, often with the heels rolling in than that what would be required for normal walking biomechanics. The mechanical mal- alignment of over-pronation is common in all age groups and occurs as a part of the natural development process of a child’s foot. In a child as the bones are forming over time, and the structures are becoming strengthened as required for walking and running. This usually resolves by the time the child is 3 to 5 years of age. If however, your child still has ‘flat feet’ or is getting leg pains at night by the age of 3, it is important to get this evaluated by our podiatrists.
Although your child may grow up to have a flat feet or low arches excessive pronation can later contribute to foot, ankle, leg, knee, hip and lower back pains with such an unsupported posture which can be corrected
Supination – Supinated Foot Type (High Arched Feet)
Less common in society but similarly to as a flat feet can cause problems with the lower limb alignment with walking and running biomechanics of the rest of the body. A child that presents with a high arch or feet that roll out can increase the risk of injuries such as ankle sprains and fractures as because as the child’s foot rolls outwards, making it stiff and potentially less stable to stand.
Tip toe or walking on the balls of the feet can occur very early, as your child is beginning to learn how to walk between 12-20 months. Most children will stop toe walk ing, however sometimes this can occur with neuromuscular diseases such as:
- Cerebral palsy
- Muscular dystrophy
- Muscular atrophy
Often muscular causes such as a tight Achilles tendons, calves however there is in some cases such as autistism that may walk on their toes. The complications with toe walking is that the gait becomes imbalanced and awkward and unstable which can lead to injuries
Adducted Gait (In Toeing or Pigeon Toe Walking)
If your child appears to be waking in-toed it can be attributed to a number of causes such as stemming from the hip, thigh or lower leg and feet. This condition can be functional such as muscles, tendons, ligaments or it can be structural such as bone alignment. Like a lot of leg conditions children who walk in-toed may corrects however it is important that as parents you have this assessed and if needed treated to prevent injuries and more serious conditions in their future such as lower back, hip, knee and ankle issues.
Calcaneal Apophysiitis (Heel Pain, Sever’s Disease, Growing Pains)
Severs Disease also known as calcaneal apophysiitis is associated to the inflammation of the growth plate of the calcaneaus or the heel bone. This condition is often seen in our practice in active children between the ages of 8-13 years in girls & 10-15 years in boys and the most common cause of heel pain in children.
During adolescence, bone growth plates develop in a process where cartilage is replaced by bone. It is understood that due to overuse, sudden increased in activity and rapid growth spurts this process is disrupted causing inflammation and pain when walking and running. Often children at risk for developing this condition present with either a flat or high arched feet, poor- fitting shoes, one leg is shorter than the other, or weight gain and obesity.
Osgood-Schlatter’s Disease (Knee Pain, Growing Pains)
Osgood Schlatters Disease is a condition that we see that often occurs in athletic or active children between the ages of 10 and 15. Generally this is an overuse injury of the knee in running and jumping sports. Commonly your child may complain of pain just below the knee cap with the tenderness worse during after activity or exercise.
Just like in Sever’s Disease (another growing pain), this presents as a result of the disturbance during a period of a rapid growth spurt. The growth plate in this disease or condition is an injury due to tension of a tendon of quadriceps (front thigh muscles) is located in a bony area at the top of the tibia (shin) just below the knee.
Congenital Talipes Equinovarus (Club feet)
Is the most common birth defect. This is a rigid, non- reducible or fixed congenital deformity better addressed at the earliest of ages . Studies highlights that it occurs more in males, and may occur in only one lower limb as opposed to both. The child’s legs are “bowed” or turn inwards, and feet are in a twisted position facing the centerline of the body, (clawed) so that if the child walks, it is on the outside edge of the foot.