It’s completely natural to want the best for your child. And this is especially true when it comes to their health and happiness.
That means you want your child to have every opportunity possible. Unfortunately, foot and ankle pain are health issues that can take away both happiness and opportunities. Our goal is to restore your child’s foot health, so they find relief from pain and regain an ability to pursue favorite activities.
One of the ways we might relieve your child’s foot or ankle pain and restore functionality is with a pair of orthotics.
What Exactly Do We Mean by “Orthotics”?
Put simply, these are customized shoe inserts that are generally categorized as being either accommodative or functional in nature. Accommodative orthotics are inserts typically used to address structural issues in the feet. They tend to be made from softer materials and provide additional cushioning in specifically targeted areas.
Functional orthotics, on the other hand, are prescribed to restrict abnormal biomechanics. Whereas accommodative children’s orthotics devices are usually softer, functional orthotics are constructed from more rigid materials necessary for regulating foot motion.
At this point, we need to mention that “custom” orthotics are just that, custom. Shoe inserts available at retail stores and national pharmacy chains are the same for everyone, and considered to be “one size fits all.” Those inserts do have some value. They can offer extra cushioning—albeit, not in the same way an accommodative orthotic provides customizable levels for specific areas—and additional arch support, but it is important to keep in mind that off-the-shelf inserts are not intended to treat medical conditions. The custom orthotics we prescribe are versatile medical instruments, able to benefit a number of lower limb conditions. At the same time, we don’t use them for every patient.
Since they aren’t always prescribed, how can you know if your child needs orthotics? Often, an identifying factor is an abnormal gait pattern. If you’re unfamiliar with the term, “gait” simply refers to the manner in which a person walks and the biomechanical processes he or she uses in doing so. There are many instances when a child’s gait pattern isn’t quite what you would normally expect to see. When this is the case, we need to evaluate the situation and determine if orthotic management will be beneficial based on diagnosis.
Resolving Child Gait Problems with Orthotics
As a starting point, let’s address a couple of problems patients sometimes think can benefit from orthotic therapy, but actually, do not – intoeing and out-toeing. In these respective conditions, feet either point inward or outward based on several different root causes:
- Tibial torsion – an abnormal inward or outward twisting of the shinbone (tibia)
- Femoral anteversion – an abnormal inward or outward twisting of the thighbone (femur)
- Metatarsus adductus – the feet themselves have an unusual inward curve (only causes intoeing)
In-toeing and out-toeing issues can range in severity and may or may not cause problems for a child. If you are concerned with a son or daughter’s gait pattern, bring them in for an appointment and we can assess the situation. In the event treatment is needed, you can take comfort knowing that we have been able to help many children overcome the difficulty in their lower limbs. Sometimes gait abnormalities aren’t a matter of the direction feet point, but instead are related to issues with arch height – and especially in cases of flat feet.
When you notice your child has flat feet, it can raise a red flag in your mind. You may find yourself wondering if your child is in pain or will he or she ever be able to walk with a normal gait. We are happy to let you know the odds are quite good the condition isn’t causing pain and your child will likely be able to walk just fine. Often, when low-to-no foot arches are observed in children, the condition is flexible flat feet. The “flexible” designation is important to note. Whereas “rigid” flat feet are more concerning, flexible ones tend to be fairly common.
You can recognize flexible flat feet when a child’s foot arches will disappear when weight is placed upon the feet – such as when a child walks or stands. Once the weight is removed—when a child sits or stands on tiptoes—the arches will reappear. Most children are actually born with this condition (even if it takes some time to show). The explanation for this is simply because the foot of the arch doesn’t fully develop until around age 4. Further, the arches can be obscured by fat pads during the first couple of years, which gives the appearance of flat feet.
When there aren’t any present symptoms—no pain or difficulty—there is usually no need for treatment. In such cases, the best practice is generally to monitor the condition and re-evaluate it periodically (to ensure it isn’t becoming a problem). When treatment is needed for a case of flexible flat foot, we will likely use prefabricated pediatric orthotics to resolve the problem.
Flat feet can cause more serious problems, however. This is typically seen in more active kids. If your child experiences pain, fatigues easily, and starts to withdraw from activities they normally enjoy, these are signs of an issue – one we can address!
A pair of custom orthotics can support your child’s foot structure, improve functionality, and relieve painful symptoms. Plus, they are easy to use. You simply slip them into your son or daughter’s shoes and the orthotics do the rest!
For a case of pediatric flatfoot, we may incorporate other elements (beyond orthotic management) into our treatment plans, such as shoe modification, change in activities, and physical therapy.
Orthotic Therapy and Juvenile Bunions
It is possible for flat feet to play a role in a different medical issue – juvenile bunions.
People often associate bunions with women’s footwear—specifically, high-heeled models like pumps and stilettos—and do not realize this condition can affect children. The fact of the matter is bunions can develop at any age and for either gender (even though the majority of bunion cases are for adult females).
Flat feet and bunions can be related because the arch of the foot plays a role in a normal biomechanical process known as pronation. When the arches are low, a foot overpronates. This means its inwards rotation is excessive. In turn, that places extra force on the inner edge of the foot, and especially at the base of the big toe.
When this happens, the metatarsophalangeal (MTP) joint connecting the toe to the foot becomes unstable and is forced out (protruding along the inner edge of the foot). This causes the big toe to angle inward.
Bunions are progressive. Part of this means that the condition will continue to worsen when left unaddressed. Now, the only way to truly correct a bunion is through surgical intervention. That being said, conservative care can help to relieve symptoms and prevent (or even stop) progression. Since we take every measure possible to avoid surgery for our patients, especially children, a key component of juvenile bunion treatment is orthotic management.
Custom orthotics allow us to modify processes that contribute to the development and exacerbation of bunions. Intervening and prescribing orthotics early can potentially spare your child significant pain in the long run.
Using Orthotics to Resolve Limping for Children
There are a variety of conditions that can cause children to limp. When any of them develop, orthotic management might be part of the treatment plan we create to address it. These conditions include:
- Sever’s disease – This condition—the most common source of child heel pain—develops as a result of varying rates of physical development for a growth plate located in the back of your child’s heal and the Achilles tendon.
- Juvenile arthritis – Too often, people assume that arthritic conditions only affect the elderly. When experienced by younger patients, we refer to it as juvenile arthritis and it can cause swelling and pain in a child’s bones and joints.
- Irritable hip – This is a fairly common condition that occurs due to the lining in the hip joint becoming inflamed.
- Transient synovitis – Illnesses that cause inflammation throughout the body (like this one) may result in joints that have temporarily swollen and become painful.
Depending on the specifics of your child’s case, we may prescribe orthotics to address any of these issues and help your son or daughter have a more normal, natural gait.
Comprehensive Foot Care for Children in Our Community
There are other conditions that might be treated with orthotic management, but here’s the deal:
Orthotics are used to treat conditions that cause foot pain and dysfunction. If your child has such a problem, aggressive, conservative care is the solution. Our team at Pediatric Foot & Ankle will treat your son or daughter with gentle, yet effective podiatric care.
Contact us today for more information or call (480) 497-3946 for an appointment.
