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Common Children's Foot Conditions

Development- tick! Shoes and their characteristic- tick! Now onto common children's conditions.

Most common kids conditions are just that - common, and unlikely to be of major concern. Although sometimes we need to rule out nasty things, which is why we spend an hour with all our new patients to work out what condition it is, and make sure it isn't serious and doesn't need to involve someone higher up the medical food chain.

We will start with what is most easily the biggest concern, the complex and often misunderstood - kids (pediatric to sound fancy) flat feet.

As previously discussed kids feet are very flexible and flat up until the age of 9 or 10 or even slightly older. Combine this with excess puppy fat and they can look very 'flat footed'. When we look at a kid that is walking, running and playing pain free, keeping up with kids of similar age, and has met their developmental milestones BUT has a flat foot posture - we arent too concerned as this kid is developing within normal guidelines.

However, there are lots of other factors we consider such as hereditary (parents feet) problems or functional factors such as muscle strength or hypermobility just to name a few. The podiatry profession can't get consensus on when to start treatment of some sort, some treat early, some wait and see. We like to think each child needs in-depth assessment and their treatment plan is dependent on what is best for them and the sports and activities they are partaking in. Concerned? Book in and let's chat and answer your questions.

Commons conditions in the early years are mainly related to birth history. For example, a condition that is not that common and is usually picked up by the maternal child health nurses (PS. We are very lucky to have these stars in our health system) is club foot (talipes abducto valgus- fancy name). This is where the childs foot is turned in on itself. Instead of re-inventing the wheel, here is the Royal children's hospital hand out on club feet. This is a serious condition but very treatable should it be diagnosed early. If you have some time after reading this blog, take a look at this great charity doing amazing things in countries that don't have maternal child health nurses - Walk for life Bangladesh

A similar condition is 'in toeing/out toeing'. Similar in the fact it can be related (but not always) to the position of the babys foot in the uterus. These rotational conditions can be understood by thinking of your feet as hands on a clock (as ironic as that is) – if your feet are pointing between 11 and 1 o’clock this is generally considered ‘normal’. However, if your feet rotate out of this zone (9 or 10 o’clock for the left foot, 2 or 3 o’clock for the right foot), then they would be considered externally rotated. On the other end, if your feet are pointing inwards, or even overlapping, they are internally rotated. These conditions can originate from 3 main areas; your hips and their position, your knees/legs and their position and your feet and their position. Each structure has different normal values and different treatment guidelines. The further up the body, the more likely we might be to get a physio involved to help with the diagnosis and treatment.

A key indication that your child may need treatment is excessive tripping; kids are clumsy, they fall over often but again consider kids of a similar age. If you feel that your kid may trip over too much in comparison to other kids their age, they may literally be ‘tripping over their own feet’ and need a little help. The other indicator is one side being very different to the other and it may likely require treatment. Again, this can be, and generally is, picked up very early if serious enough. Once we are getting into the later years of development these things are harder to change but its still worth coming in and having a discussion if you are concerned. Again here - is the Royal children's hospital hand out link.

A more complex and interesting condition is toe walking. This condition has many causes. Interestingly, toe walking has been linked to autism, cerebral palsy and to many other conditions. It's a complex condition that can even present for no particular reason. It is classified by the severity of which the child avoids placing their heels on the ground when walking. It can be because they do not like the sensation of the ground on their heels, or the Achilles' tendon is genetically shortened, or it can be because the nervous system does not allow heel contact or muscle tone is making heel contact difficult. We will often discuss these kids with other health professionals. Toe walking is complex but getting a diagnosis is super important.

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