Blog Archives

Summer and your feet | The Podiatrist and yourfeetnz

foot-soak-bowl

Ok so now that summer is officially in full swing (well kind of) it may be time to actually take some time to pamper those little puppies walking around in flip-flops and going bare in the sand.  Not only are your feet much more visible than they are in other seasons during the hot summer months, but they can also suffer more from increased walking and from less than supportive shoes.

This being the case, it might be a good time to think about giving your feet a little R and R.

Basic foot care involves some, well, basic tips.

First of all it is important to wash your feet every day in order to insure that bacteria and fungus don’t get a chance to grow.  Even when you are not showering, you should take the time therefore to wash your feet.  This is even more important when walking around in flip flops or sporting bare feet on the beach because your feet will be exposed to a great deal more of these unpleasant germs.

Always be sure to wash between the toes as well as over the foot itself. You also should avoid trimming or shaving off calluses no matter how tempting that little shaver at the pedicurists might be.  While your feet may be smoother than ever for a few days, thick layers of dry skin will grow back and you may be exposing yourself to a risk of infection.

Consult The Podiatrist if you are having trouble with stubborn corns and calluses.
Always wear shoes that fit properly. Walking around in tight fighting shoes will leave you at least hobbling. Because your feet swell and sweat in the heat, shoes without socks can become especially uncomfortable as your feet slip and rub against the shoe.  Make sure you have broken in your shoes before taking a long walk and make sure that they fit before buying them.  No matter how cute that little pair of ballet flats might be, if they don’t have your size then do let them go.
Tips on how to take care of our feet during these hot and sticky summer months.

It’s easy to forget that feet can get sunburned. Be sure to apply sunscreen with a minimum SPF of 50 when barefoot or if feet are exposed through open sandals, and don’t forget to apply to both the tops and bottoms of your feet.

With sandals and open shoe styles, feet are exposed to the elements. Dry, cracked heels are common during the summer months so make an effort to moisturize daily. The Gehwol Fussfraft foot care range have a balm for every skin type.

Keep Feet Clean: Foot perspiration is typical in the summer and can lead to fungal infection and unwanted odor. Wash feet daily, and let them dry thoroughly before putting shoes on. Also, consider using a foot powder to minimize odour. Why not try the Gehwol Herb Bath Salts, and use the Gehwol Fussfraft Mint balm- ideal for cooling the feet.

Add Cushion: When wearing high heels, your feet are feeling the pressure. Cushion the impact with an insole like Podsoft Foot Angles.

Sandals and jandals: with warmer weather, people tend to be more active and on their feet. To relieve tired, achy feet add extra support in your shoes. The Vasyli range of medical sandals are ideal for the summer.

Having perfectly manicured toes can make for a nice beach time public display but if you forget to follow these basic guidelines your feet will be more disaster than delight.  Remember always that your feet are important so to treat your them to a little basic pampering every day.If you have any concerns, please feel free to contact us.

Get started on resolving your foot problem today.

http://www.thepodiatrist.co.nz

Flat feet- Children’s feet | The Podiatrist and yourfeetnz

 

podiatrist-podiatry-feet-auckland-caron-orelowitz1.jpg

Children with flat feet, also called pes planus, have a flattening of the arch during standing and walking.

Flat foot is normal in infants and young children. At this age, in the absence of any associated symptoms, treatment is highly debatable.

Flat foot usually naturally corrects itself as muscles strengthen and soft tissues stiffen. The height of the arch in the foot increases with age until about 9 years. The problem is when flat foot persists, spontaneously occurs in older children or later in life, or is associated with pain and disability.

Flat feet can be flexible or rigid, painful or painless and associated with a tightness of the calf muscles (Achilles tendon). The majority of flat feet are painless, but when pain is present it is usually during weight-bearing activities such as walking and running. The pain can be in the sole of the foot, the ankle, or non-specific pain all around the foot area.

 

What causes flat feet?

A complex and sophisticated interaction of bones, ligaments, muscles and nerves within and above the foot defines its anatomy and function. Anything that interrupts the integrity of these structures leading to a collapsed arch can cause symptomatic flat feet.

Examination of the foot begins with an examination of the entire child, because the flat foot may have an underlying cause.

Flat foot can also originate from unusual anatomy such as a tarsal coalition (bones joined together), ligament or muscle damage, restricted ankle movement, outward rotated lower legs, and knock knees (where the legs bow inwards at the knee). Obesity can result in collapse of the arches by the increased load on the foot. If knock knees also develop, the middle of the foot will tend to turn out (abduct). The foot will point outwards when walking, instead of straight ahead, which is inefficient and can cause early fatigue.

Footwear in early childhood has been thought to cause flat foot. It is likely that children who wear shoes, are not physically active and have flat feet will have decreased muscle activation in their feet and thus impaired foot function and weakness.

Some older children and adolescents develop flat feet in the absence of any disorder or associated factors.

 

Does flat foot need to be treated?

Flat feet require treatment only if clearly associated with pain or decreased function. Managing the underlying cause or disease is of highest priority; just treating the symptoms should be secondary.

If flat foot is observed in a child who is overweight and has knock knees, or in a child with excess joint flexibility and poor footwear, each of these factors could be contributing to the symptoms, and each should be addressed.

If a child’s quality of life is affected by how their feet look, feel or function, then the associated issues should be addressed.

For any foot problems, contact The Podiatrist.

http://www.thepodiatrist.co.nz

http://www.kidsnmotion.co.nz

5 quick and easy tips to healthy feet and legs | The Podiatrist and yourfeetnz

one pair has to last a lifetime

There are many causes of leg pain right from muscle cramps and inflammation of tendons to arthritis, varicose veins and nerve damage. Leg pain due to muscle strain following an injury or wearing tight shoes for a long time can be prevented by following few simple tips:

  1. Stretch the leg muscle: One of the most effective ways to prevent leg pain due to a sudden muscle twist or cramp is to stretch the muscle. This not only improves blood flow to the injured muscle but it also helps in reducing muscle tension thereby relieving muscle soreness.
  2. Take a warm shower: If you suffer from leg pain, then take a warm shower to relax the muscles. If taking a bath is not feasible, then placing a heating pad on the affected areas can also help. A heat pack works best if the pain is due to a previous injury as it not only relaxes blood vessels but also improves blood circulation, alleviating leg pain.
  3. Wear a proper fitting athletic shoe: Most people fail to choose the right fitting shoe, which is one of the common causes of leg and heel pain. To get the right fit, determine the shape of your foot using the ‘wet test’. For this, step out of the shower onto a surface that will show your footprint, like a brown paper bag. If you have a flat foot, you will see an impression of your whole foot on the paper. If you have a high arch, you will only see the ball and heel of your foot. When shopping, look for athletic shoes that match your particular foot pattern.
  4. Choose the right sports shoe: Not many people are aware that different types of shoes are specially designed to meet your sports requirement. Did you know running long distances in court-style sneakers can contribute to shin splints? It is important to choose the shoes according to your sport or fitness routine.
  5. Go slow if you are a beginner at the gym: One of the common mistakes that most people commit is to overexert on the first day of the gym, which not only exerts pressure on the knee but also causes muscle soreness and leg pain. The key to preventing leg pain and sticking to your workout routine is to build your fitness level slowly. You can start off with less strenuous workouts and then gradually increase the duration, intensity, and frequency of your exercise regimen.

For any foot problems, contact The Podiatrist.

http://www.thepodiatrist.co.nz

 

Foot problems in children may become serious if untreated | The Podiatrist and yourfeetnz

The importance of looking after your child's feet

 

Issues with feet can affect anyone at any age. Parents shouldn’t assume that signs of foot problems in children are merely “growing pains.

Managing children’s health is complicated enough, especially for first-time parents. It can be a struggle to truly know and even understand which signs and symptoms are temporary and which point to more serious concerns.

In truth, the professionals a The Podiatrist and Kidsnmotion agree that there are some pediatric foot problems that resolve themselves with growth and time. However, there are clear signs when children need medical help.

Common foot problems can range from pediatric flat foot, toe walking, in-toeing and flat or high arches to tarsal coalitions (an abnormal bridge of tissue that connects two normally separate tarsal bones plus extra bone growth — quite simply, when the bones of the feet fail to separate during fetal development).

While these conditions of the feet and their treatments are different, they share some common signs that show parents there is a problem that needs to be addressed:

  •  Pain, swelling and redness that does not subside
  •  Development of thick calluses in one area of the foot
  •  Problems with the way your child walks
  •  Shins or thighbones that appear to turn inward
  •  Ankles that are weak or easily give out

As much as your child’s general health and well-being is important, do not ignore symptoms; foot health is just as important as any other medical examination.

There are several treatment options for these conditions. Whether a less invasive approach — such as shoe modifications, orthotic devices and physical therapy — or a more intensive intervention — such as bracing, steroid injections or even surgery — is needed, The Podiatrist can advise parents on which treatment offers the best long-term prognosis.

If you believe that a family member is experiencing any of the above symptoms, perhaps it’s time to seek professional help and book a consultation for a thorough examination, diagnosis and possible treatment with The Podiatrist.

 

www.thepodiatrist.co.nz

www.kidsnmotion.co.nz

 

Common Childhood Orthopaedic Conditions

baby standing

As time passes, you may notice that your child’s growth isn’t occurring completely on the straight and narrow. Many kids exhibit flatfeet, toe walking, pigeon toes, bowlegs, and knock-knees in their first years of life.
Some of these conditions correct themselves without treatment as kids grow. Others that persist or become more severe may be linked to other conditions. Many orthopedic conditions, just like dimples or cleft chins, are just normal variations of human anatomy that don’t require treatment.
Flatfeet
Most babies are born with flatfeet and develop arches as they grow. But in some kids the arch never fully develops. Parents often first notice their child has what they describe as “weak ankles.” The ankles appear to turn inward because of the way the feet are planted.
Flatfeet usually do not represent an impairment of any kind, and The Podiatrist only considers treatment if it becomes painful.
Toe Walking
Toe walking is common among toddlers as they learn to walk, especially during the second year of life. Generally, the tendency goes away by age 2, although it persists in some kids.
Intermittent toe walking should not be cause for concern, but kids who walk on their toes almost exclusively and continue to do so after age 2 should be evaluated by The Podiatrist. Persistent toe walking in older kids or toe walking only on one leg might be linked to other conditions, such as cerebral palsy or other nervous system problems.
In-Toeing (Pigeon Toes)
In-toeing (medical name: femoral anteversion), or walking pigeon-toed (with feet turned inward), is another normal variation in the way the legs and feet line up. Babies may have a natural turning in of the legs at about 8 to 15 months of age, when they begin standing.
Treatment for pigeon-toed feet is almost never required. Special shoes and braces commonly used in the past were never proved to speed up the natural slow improvement of this condition. In-toeing typically doesn’t interfere with walking, running, or sports, and resolves on its own as kids grow into teens and develop better muscle control and coordination.
Bowlegs
Bowleggedness (medical name: genu varum) is an exaggerated bending outward of the legs from the knees down that can be inherited. It’s common in infants and, in many cases, corrects itself as a child grows.
Bowleggedness beyond the age of 2 or bowleggedness that only occurs in one leg but not the other can be the sign of a larger problem, such as rickets or Blount’s disease. Rickets, a bone growth problem usually caused by lack of vitamin D or calcium in the diet, causes severe bowing of the legs and can also cause muscle pain and enlargement of the spleen and liver. Rickets is much less common today than in the past. Rickets and the resulting bowlegs are almost always corrected by adding vitamin D and calcium to the diet. Some types of rickets, however, are due to a genetic condition and may require more specialized treatment by an endocrinologist.
Blount’s disease is a condition that affects the tibia bone in the lower leg. Leg bowing from Blount’s disease is seen when a child is about 2 years old, and can appear suddenly and quickly become worse. The cause of Blount’s disease is unknown, but it causes abnormal growth at the top of the tibia bone by the knee joint. To correct the problem, kids may need bracing or surgery when they’re between 3 and 4 years old.
You should also take your child to The Podiatrist if bowleggedness occurs only on one side or gets progressively worse.
Knock-Knees
Most kids show a moderate tendency toward knock-knees (medical name: genu valgum) between the ages of 3 and 6, as the body goes through a natural alignment shift. Treatment is almost never required as the legs typically straighten out on their own. Severe knock-knees or knock-knees that are more pronounced on one side sometimes require treatment.
If you have any concerns, see The Podiatrist
http://www.thepodiatrist.co.nz
http://www.kidsnmotion.co.nz

In-toeing and Out-toeing in Toddlers

intoeing and toeing out in children

Whether your baby rises from a crawl with a shaky first step or a full-on sprint across the living room, chances are you’ll be on the edge of your seat. But remember — a child’s first steps usually aren’t picture perfect.
Learning to walk takes time and practice, and it’s common for kids to start walking with their toes and feet turned at an angle. When feet turn inward — a tendency referred to as walking “pigeon-toed” — in-toeing. When feet point outward, it’s called out-toeing.
It can be upsetting to see your child develop an abnormal gait, but for most toddlers with in-toeing or out-toeing, it’s usually nothing to worry about. The conditions do not cause pain and usually improve as kids grow older.
Almost all healthy kids who toe-in or -out as toddlers learn to run, jump, and play sports as they grow up, just the same as kids without gait problems.
In-toeing and Out-toeing
Most toddlers toe-in or -out because of a slight rotation, or twist, of the upper or lower leg bones.
Tibial torsion, the most common cause of in-toeing, occurs when the lower leg bone (tibia) tilts inward. If the tibia tilts outward, a child will toe-out. When the thighbone, or femur, is tilted, the tibia will also turn and give the appearance of in-toeing or out-toeing. The medical term for this is femoral anteversion. In-toeing can also be caused by metatarsus adductus, a curvature of the foot that causes toes to point inward.
The reason some kids develop gait abnormalities and others don’t is unclear, but many experts think that a family history of in-toeing or out-toeing plays a role. So, if you toed-in or -out as a child, there’s a chance that your child could develop the same tendency. Additionally, a cramping of the fetus in the womb during pregnancy could also have led to in-toeing or out-toeing.
As a fetus grows, some of the bones have to rotate slightly to fit into the small space of the womb. In many cases, these bones are still rotated to some degree for the first few years of life. Many times this is most noticeable when a child learns to walk, because if the tibia or femur is tilted at an angle, the feet are, too.

Does Walking Improve?
As most kids get older, their bones very gradually rotate to a normal angle. Walking, like other skills, improves with experience, so kids will become better able to control their muscles and foot position.
In-toeing and out-toeing gets better over time, but the change occurs very gradually. And, it’s hard to notice. Parents can record their child walking, and then wait about a year to take another video. This usually makes it easy to see if the gait abnormality has improved over time. In most cases, it has. If not, parents should speak with their child’s doctor to discuss whether treatment is necessary.
If Walking Does Not Improve
Speak with The Podiatrist if you’re concerned about the way your child walks. For a small number of kids, gait abnormalities can be associated with other problems. For example, out-toeing could signal a neuromuscular condition in rare cases.
Have your child evaluated by The Podiatrist if you notice:
in-toeing or out-toeing that doesn’t improve by age 3
limping or complaints of pain
one foot that turns out more than the other
developmental delays, such as not learning to talk as expected
gait abnormalities that worsen instead of improve
If you are at all concerned, contact The Podiatrist
http://www.thepodiatrist.co.nz
http://www.kidsnmotion.co.nz

Shoes that make the grade

Children’s feet change with age. Shoe and sock sizes may change every few months as a child’s feet grow.

  • Shoes that don’t fit properly can aggravate the feet. Always measure a child’s feet before buying shoes, and watch for signs of irritation.
  • Never hand down footwear. Just because a shoe size fits one child comfortably doesn’t mean it will fit another the same way. Also, sharing shoes can spread fungi like athlete’s foot and nail fungus.
  • Examine the heels. Children may wear through the heels of shoes quicker than outgrowing shoes themselves. Uneven heel wear can indicate a foot problem that should be checked by a podiatrist.
  • Take your child shoe shopping. Every shoe fits differently. Letting a child have a say in the shoe buying process promotes healthy foot habits down the road.
  • Always buy for the larger foot. Feet are seldom precisely the same size.
  • Buy shoes that do not need a “break-in” period. Shoes should be comfortable immediately. Also make sure to have your child try on shoes with socks or tights, if that’s how they’ll be worn.
  • Consider closed toe shoes. Covering the child’s toes allows for more protection.

Do Your Child’s Shoes “Make The Grade?”

  • Look for a stiff heel. Press on both sides of the heel counter. It shouldn’t collapse.
  • Check toe flexibility. The shoe should bend with your child’s toes. It shouldn’t be too stiff or bend too much in the toe box area.
  • Select a shoe with a rigid middle. Does your shoe twist? Your shoe should never twist in the middle.
  • Are the shoes secure on the foot? Laces or Velcro are best to hold the foot in place.

Additional Advice for Parents

  • Foot problems noticed at birth will not disappear by themselves. Do not wait until children get older to fix a problem. Foot problems in youths can lead to create problems down the road.
  • Get your child checked by The Podiatrist. A lack of complaint by a youngster is not a reliable sign that there is no problem. The bones of growing feet are so flexible that they can be twisted and distorted without the child being aware of it.
  • Walking is the best of all foot exercises. Observe your child’s walking patterns. Does your child have gait abnormalities? Correct the problem before it becomes a bigger issue.
  • Going barefoot is a healthy activity for children under the right conditions. However, walking barefoot on dirty pavement can expose children’s feet to the dangers of infection through accidental cuts and to severe contusions, sprains or fractures. Plantar warts, a virus on the sole of the foot, can also be contracted.

Children’s sports-related injuries are on the rise. A child’s visit to The Podiatrist can help determine any concerns there may be regarding the child participating in specific sports and help identify the activities that may be best suited for the individual child.

Visit The Podiatrist for any concerns you may have.

http://www.thepodiatrist.co.nz

http://www.kidsnmotion.co.nz

Taking care of your feet is not child’s play

A day in the sun can end with a day at the doctor’s office if the proper safety measures are ignored. Before children catch a glimpse of the giant slide at the pool, the oversized toys at the park or the exciting rides at the amusement park, prepare them with the right footwear and protect them with the right care.

– Carefully observe your child’s walking patterns. Does your child have toes that point in or out, have knock-knees or other gait abnormalities? These problems can be corrected if they are detected early and treated by aThe Podiatrist.

– Children’s feet change size rapidly, so always have your child’s feet measured each time you purchase new shoes.

– When shopping for shoes, look for stiff material on either side of the heel, adequate cushioning and a built-in arch. The shoe should bend at the ball of the foot, not in the middle of the shoe. Never wear hand-me-down shoes.

– Limit the time children wear platform or heeled shoes and alternate with good quality sneakers or flat shoes. High-tops generally help prevent ankle sprains.

– Don’t buy shoes that need a “break-in” period. Good shoes should feel comfortable right away. For athletic activities, choose a shoe that is designed for the sport your child will be playing.

– Never pack brand-new shoes for your children to wear on vacation.

– Walking barefoot on pavement, hotel or airplane carpeting, in hotel bathrooms or a locker room and near the pool can make your child susceptible to a host of infections. Always wear a pair of flip-flops or strappy sandals made of soft, supple leather to prevent contracting a bacteria or fungus like athlete’s foot or plantar warts.

– When applying sunscreen, don’t forget to put some on your child’s feet. Additionally, always remember to re-apply.

– Lack of complaints by a youngster is not a reliable sign. The bones of growing feet are so flexible that they can be twisted and distorted without the child being aware.

– Be careful about applying home remedies to children’s feet. Preparations strong enough to kill certain types of fungus can harm the skin.

Your best bet is to visit The Podiatrist.

www.thepodiatrist.co.nz

www.kidsnmotion.co.nz

www.scooters.net.nz

Quality Paediatric Foot Care at Kids ‘n Motion Podiatry

Kids ‘n Motion Podiatry- Leading Podiatrist in Children’s Foot Problems, invites parents to bring their children into the one of its kind in Auckland- a child specific Podiatry practice. The clinic has a friendly environment and is ideally set up for assessing children of all ages (lots of fun activities). Parents are asked to be cautious of the health of their children’s feet to help maintain a healthy, active life style.

Children with strong, healthy feet avoid many kinds of lower extremity problems later in life. That is why it is important to inspect your children’s feet periodically. If a problem is suspected, I encourage you to bring your children into the clinic for evaluation. It is always our joy to make sure our paediatric patients remain fit, and active with healthy feet.

The size and shape of an infant’s feet change quickly during their first year. Because a baby’s feet are flexible, too much pressure or strain can affect the shape of their feet. It’s important to allow an infant to kick and stretch their feet freely. The Podiatrist also suggests that parents make sure their baby’s shoes and socks do not squeeze the toes, as this can cause painful foot conditions.

For toddlers, it is important to not force them to walk before they are ready. Once walking begins naturally, watch the toddler’s gait. Many toddlers have a pigeon-toe gait, which is normal. Some will initially learn to walk landing on their toes instead of their heels, but most children outgrow both of these problems. The Podiatrist informs parents that conditions detected early can be treated more easily than waiting for pain to occur.

The foot’s bone structure is well-formed by the time children reach age seven or eight, but if a growth plate (the area where bone growth begins) is injured, the damaged plate may cause the bone to grow oddly. With The Podiatrist’s care, however, the risk of future bone problems is reduced.

The Podiatrist urges parents to check their child’s show size often, making sure there is space between the toes and the end of the shoe and that the shoes are roomy enough to allow the toes to move freely. Whether children are experiencing heel pain, knee pain, or any other conditions, The Podiatrist invites parents to bring their children in.

Kids ‘n Motion Podiatry is committed to providing patients with exceptional care.

www.kidsnmotion.co.nz

http://www.thepodiatrist.co.nz

Children’s Feet Require Your Special Attention

Patients often have questions for The Podiatrist if they notice something unusual about their child’s feet or the way the child walks or runs. For many years, the most common pediatric foot problem seen in doctors’ offices has been in-toeing, especially whenever the child is observed while running.

Let’s briefly discuss several of the more common paediatric foot conditions that result in the feet turning inwards, as well as how these conditions can (and should) be managed by The Podiatrist.

A case relating to paediatric in-toeing often begins when the parent reports an abnormal appearance of the child’s foot, an awkward gait or a “clumsiness,” with a tendency to trip or fall. A structural and biomechanical examination of the lower extremities – including watching the child walk – will allow for differential diagnosis and appropriate treatment recommendations. In-toeing is generally caused by the following three conditions, whose corrective timing and treatment considerations vary.

Tibial Torsion

Tibial torsion is a common condition in which the tibia has not completed its external rotation to normal adult position (resulting, therefore, in a lack of normal torsion). The key to diagnosis is the closed-chain postural evaluation. On standing examination, the child’s knees face forward while the ankles and feet turn inward.

The natural history of tibial torsion is a gradual normalization with growth and use of the lower leg muscles. Most cases resolve by 2 years of age, but rotation values continue to increase an average of 1.5 degrees a year up to age 6. By age 7, the vast majority of children have achieved normal adult position.There is a familial tendency among those who fail to reach normal values. When tibial torsion persists, compensatory pronation commonly develops.

Suggested Care:

Parents need to be involved in the care of their children. Train parents to frequently stretch the medial soft tissues of their child’s lower leg. Show them how to strengthen the peroneal muscles (using a home exercise program and an extremity rehab system) when the child is old enough to cooperate sufficiently.

In addition, recommend buying shoes for the child that have flexible soles and good support to decrease pronation stresses. In cases of hyperpronation, individually designed paediatric orthotics should be considered. Finally, recommend beneficial activities and sports that emphasize lower-leg training and coordination (such as soccer)

Femoral Torsion

Femoral torsion is an inward (medial) rotation of the entire lower leg that begins at the neck of the femur. It is a relatively common childhood condition, one which can be recognized by the medial facing of the knee as well as the ankle and foot. With walking, more than 90 percent will resolve by the 8th year.

Any persistence is thought to be due to ligament laxity of the hip joint capsule. In such cases, physical examination will find excessive passive internal hip rotation. Lumbar hyperlordosis, genu recurvatum, and hyperpronation are frequently associated.

 

Suggested Care:

Begin strengthening the external rotator muscles and extensors of the hip by using an extremity rehab system. Parents can passively stretch the hips into external rotation, and the child should be encouraged to sit cross-legged.

Let parents know that shoes with good support are very important. When hyperpronation is noted, individually designed stabilizing orthotics are indicated to prevent further problems. Also, encourage physical activities such as ballet, skating and bike riding – all of which tend to engage the external rotator musculature of the hips.

Metatarsus Adductus

Metatarsus adductus (also known as a “hooked foot”) is a contracture of the medial soft tissues of the foot. This condition has been found to be present in 6 percent of schoolchildren. On examination, the in-toeing can be passively stretched to normal, since there is no bony abnormality associated.

More than 90 percent of infants with this condition will resolve by the age of 18 months. When more than mild adduction persists beyond 1 year of age, a consultation with The Podiatrist or orthopedic surgeon for consideration of casting is appropriate. However, casting and special foot braces are seldom necessary.

Suggested Care:

Instruct parents to massage and stretch the medial soft tissues of the infant’s foot for several minutes following each diaper change. Frequent stretching is the key. Consider an evaluation by a specialist if significant adduction persists beyond 1 year of age, or if the deformity feels fixed and cannot be temporarily reduced with gentle stretching. Orthotics are needed only if mild adduction continues beyond age 7.

Footwear: What to Look for Developing feet require proper footwear. Whenever safety and comfort allow, going barefoot stimulates proprioceptors and encourages muscular coordination and strength. Children’s shoes should have flexible soles to allow for proper foot-joint movement (thick rubber soles may hamper and confine).

Proper shoe sizing and fit are critical, since the developing bones are soft and malleable. Tight, constricting shoes will interfere with normal growth and may result in deformity. Frequent evaluation of shoe size and fit (palpate the child’s foot for pressure points while they are standing with shoes on) is an important concept for parents.

When to Recommend Orthotics

As described above, the majority of paediatric foot problems will resolve with normal childhood activities, exercise and proper footwear. Orthotics are seldom needed in the early years of growth. If excessive pronation associated with in-toeing is seen to persist beyond the age of 7 or 8, or is responding poorly to home care interventions, individually designed stabilizing orthotics are appropriate.

The additional corrective support they provide will encourage normal development while preventing further deformity and reducing abnormal kinetic-chain stresses on the pelvis and spine during formative years. Parents will need to be educated to bring their child in for regular evaluations of orthotic fit and function, since children’s feet can rapidly outgrow any orthotic.

Serving the Next Generation of Patients

Parents need reassurance and appropriate recommendations when they bring in a child with a “foot problem.” In particular, in-toeing can raise concerns in parents and may be frustrating to athletically oriented children. Most of the common causes of in-toeing in children will resolve during normal growth and development, needing only home-care recommendations and monitoring by the family’s chiropractor.

As always, the child’s developing spine should be evaluated and appropriate Podiatic care is recommended. Specific home exercises may hasten the maturation and coordination of the support muscles. In some cases, paediatric orthotics may be needed to provide additional corrective stimulus.

Should you have any questions or concerns, seek professional advice before starting any homecare.

For more information, contact The Podiatrist

www.thepodiatrist.co.nz

www.kidsnmotion.co.nz