Our feet are complex structures composed of 26 bones, that’s a lot! The bones muscles and ligaments are designed to support the entire body weight on uneven surfaces and have the ability to absorb shock. Most of the foot’s structure develops in the first two years however the bones themselves do not harden until around the age of 18 which is why assessing a child’s foot early can be crucial.
In the first three years a child’s foot grows up to 12 sizes and many children have flat looking feet that may concern a parent. However, most children are born with flat arches that develop over the next 7 to 8 years into the foot they will have into adulthood. With a good family history and normal development most arches will correct themselves at least to match their parents or grandparents. Other foot traits are also inherited for instances a child with a mild bunion and a father or aunt who had severe bunions can probably count on inheriting the trait. Thank you very much daddy! If all is normal in the development of the child and the child has a mild flatfoot chances are this does not need treatment. More severely pronated feet or a child that does not have a typical development may need to be assessed.
It is also important to see what is happening at the knee and the hip. Children who in toe or out toe significantly can be helped by a gait plate which encourages internal or external rotation. These are simple insoles which can be fit into most children’s shoes. It is important to determine where the rotation is coming from as it may involve the hip, knee, ankle or foot position.
Children should not experience pain in walking or running, even though they endure about three times more stress than the average adult foot due to their high activity and greater proportion of high-impact activities.
At Ortho Design we only treat children with orthotics when the assessment shows that self correction is unlikely. Biomechanics, gait evaluation, motor and neurological development as well as family history are all taken into consideration.
We have several types of children’s orthotics ranging from pre-sized heel cups to custom cast orthotics. With a physiotherapist’s or physician’s referral foot exams for children are free. We may however recommend monitoring the development of the foot. We will measure hind-foot inclination and can compare it at intervals to see if normal development is occurring. Good footwear can be important but it does not provide the correction that a proper arch support gives, just put your fingers into the arch area of any children’s foot and press down!!!