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Flat feet- Children’s feet | The Podiatrist and yourfeetnz
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
5 quick and easy tips to healthy feet and legs | The Podiatrist and yourfeetnz
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:
- 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.
- 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.
- 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.
- 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.
- 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
Tips For Relieving The Pain Of Sore Feet: The Podiatrist and YourFeet
Sore feet are not only uncomfortable; they can put a big dent in your productivity and turn even the simplest task into a burdensome chore. Causes for sore feet can range from ill-fitting shoes to physical deformities, but luckily there are as many different solutions as there are problems; the trick is finding what works best for you. Many common foot problems like heel spurs, flat feet and torn ligaments can be solved best by using bio-mechanical intervention that can range from drug store variety inserts to custom-made orthotic devices.
Determining the Problem
To find the source of sore feet, start with the obvious culprit, ill-fitting shoes that do not provide the proper support for your body frame. So called “sensible shoes” with low profiles, sturdy arches and ankle support often provide instant relief from minor foot issues caused by inappropriate footwear. Under some conditions, like standing on hard or uneven surfaces all day, additional relief can be provided by drug store inserts that create a layer of cushioning for your feet to reduce the impact of each step. If these simple tactics do not yield favorable results, it is wise to consult with The Podiatrist to examine your feet to determine if you are suffering from treatable foot maladies that would benefit from custom-made orthotic devices.
Orthotic Solutions
The Podiatrist can examine your foot to determine if your problem results from an injury to or is the result of the way your foot functions in relation to the rest of your body. Injuries from sports and recreational activities can often be cured by providing proper support during the recuperation process so that the injury is not irritated and can heal properly. These types of inserts, pads and braces are temporary and will eventually become unnecessary.
If the problem lies in the basic structure of your foot, however, a more permanent orthotic will be recommended that is strategically designed to make your foot function correctly when you take a step. A cast of your foot is made and The Podiatrist uses this model to create the proper orthotic out of plastic, wood or rigid rubber. This kind of treatment can not only provide relief for sore feet, it can also have a direct impact on your legs and torso because it subtly changes your posture and corrects muscular issues that stemmed from improper balance.
See The Podiatrist for any foot problems.
http://www.thepodiatrist.co.nz
Heel Pain: It may not be Plantar Fasciitis
Heel pain affects a large portion of the population, often resulting in visits to The Podiatrist. Plantar fasciitis is typically the diagnosis the patient receives during the visit; however, plantar fasciitis is only one potential cause of heel pain. The plantar fascia is a strong, dense strip of tissue that runs from the heel to the ball of the foot. Its sole job is to support the arch of the foot. .
It is easy to see how the plantar fascia may be causing all this pain as the foot impacts the ground when you think about how often the full weight of the body is concentrated on the plantar fascia. This forces it to stretch as the arch of the foot flattens from the full weight of the body, possibly leading to stress where the plantar fascia attaches at the heel bone. If this keeps up, the result can be pain caused by small tears of the fascia.
If it is not the plantar fascia then what else could be causing my heel pain?
Calf muscle weakness (muscles on the back of the lower leg) can result in referred pain directly to the heel.This is seen after someone has changed/added a workout program or modified the type of shoes they wear. This adds additional stress to the calf muscles that they may not have been ready for and lead small areas of irritation in the muscles.>
Calf muscle tightness – this causes the connective tissue surrounding the muscle to pull harder on the Achilles tendon leading to tightness at the heel, possibly resulting in the pain you’re feeling.
Sciatic nerve irritation – the nerve that runs from the low back through the hip and down the leg to the foot can get tight or pinched not allowing the nerve to move easily as you walk. This can lead to irritation of the nerve causing pain that is located at the heel. This is very common for anyone with any history of low back pain or hip pain.
Poor Posture – if you sit slumped forward most of the day the muscles and structures from the back of your neck, upper back, lower back, and hips can get tight and shortened, consequently pulling on the heel.>
Weakness of the muscles around the hip can cause muscles in the leg to shorten to help stabilize, consequently pulling on the heel.>
Why is this so confusing?
It may be hard for you to pinpoint the cause of heel pain yourself because the symptoms are the same for all of the above listed causes. No matter what the cause, you will experience pain on or around the heel when weight is placed on the foot. This is usually worse in the morning, especially with the first few steps after getting out of bed. In most cases, there is no pain at night, but this is not a rule as many of our patients report increased pain at night. Pain of typical plantar fasciitis is typically believed to decrease over the course of the day as the tissue warms up; however, patients have also reported increased discomfort as the day progresses, leading on to investigate other areas as the source or cause. Additionally, prolonged standing, walking, or getting up after long periods of sitting are commonly reported with all of the above causes. Again, the reports can be as varied as the potential causes.
Activities that make the pain worse:
Excessive running or jumping
Changing physical activity (especially for athletes)
High arches, flat feet, abnormal gait
Wearing improper shoes while walking or running
The Steps to Relieve Heel Pain
In most cases, heel pain does not require surgery and can be treated conservatively, but the first step is to obtain an evaluation by The Podiatrist who can help pin point the actual cause of the pain that’s specific to you. It is important to not treat the symptom of heel pain, but to isolate and treat the cause.
The Podiatrist may then recommend treatment , depending on the needs of your particular condition. In extremely painful conditions, your doctor may prescribe anti-inflammatory medications, and in severe cases give you a cortisone shot to address excessive inflammation.
Most people with heel pain get better with the help of The Podiatrist, but don’t wait. The longer you “live” with the pain the longer it may take to get rid of it as your body adapts. Most acute cases (less than 30 days) can get better within 6-8 weeks. Additionally, treatment should include activities that directly address the cause of your heel pain and are designed to include you in the healing process, so your participation is critical.
The Podiatrist specializes in the treatment and management of all foot related problems and will assess what is the cause of your foot/heel pain, not the symptom.
For more information or to find out if you are a good candidate for our services contact The Podiatrist
http://www.thepodiatrist.co.nz
Are your feet making you fat?
The shoes you wear can make you feel slim, sexy, and stylish—or they can leave you wincing in pain.
Ever wonder how much damage you are doing when you walk to work in sky-high heels or scuff through errands in flip-flops?
How High Heels Cause You Pain
There’s a reason most women willingly forgo comfort to squeeze their feet into stilettos: Adding inches makes you look slimmer, accentuates calf muscles, and even lifts your backside.
But you may be doing lasting damage if you live your life in heels. A 2011 Danish study found that walking in heels can increase the risk of osteoarthritis six-fold.
Tighter quads.
Imagine standing on the edge of a ski slope with your toes pointing downhill. To compensate for this tipped-forward position, it’s natural to bend your knees slightly and arch your back. As a result, your quads are forced to work overtime, which makes them tight and prone to injury. Walking with your knees slightly bent also puts 200 percent more stress on your kneecaps, which can wear away at the cartilage and increase your risk of developing arthrits.
Screaming shins.
The added height of heels puts extra strain on the shin muscles, which control the forefoot. This repetitive strain can eventually lead to painful shin splints.
Knotty calves.
Heels put your calf muscles in a shortened position. Over time, this can become permanent: One study in the Journal of Experimental Biology found regular heel wearers had calf muscles that were an average of 13 percent shorter than those of nonheel wearers, making it uncomfortable for them to walk without heels because their natural stride was thrown off.
High Heels Help
Stretch it out.
Give your calves a good daily stretch like this one from Bowman: Stand with your feet hip-width apart and place a rolled-up towel under the ball of your right foot. Lower your right heel to the floor. Once you’re comfortable here, take a small step forward with your left foot, keeping your hips square. Hold for 20 to 30 seconds and work up to 60 seconds.
Massage your shins.
Relieve shin pain with a gentle self-rubdown, applying long vertical finger strokes down the front of your lower leg. Then focus on kneading the muscles horizontally, says Bowman.
Embrace the commuter shoe.
Switch to low-heeled options for getting places, and save those skyscrapers for when you’re mostly sitting pretty.
Shop smarter
Feet swell over the day, so if a shoe feels slightly tight at 7 a.m., it’ll be a vise by nightfall. Only buy shoes that are roomy enough, and consider going lower. Research shows that 2-inch heels create impact forces 4 percent greater than flats, while 3-inch heels boost stress by 33 percent
How Flats Cause Foot Pain
Flats sound like the healthier alternative to heels, but the truth is that even a basic ballet flat or canvas casual can be just as problematic.
Many flats lack internal support (like the kind you find in a sneaker). Without it, the ligaments and tendons along the bottom of your foot can overstretch and the arch can collapse. This in turn can lead to the painful foot condition plantar fasciitis—a notoriously hard-to-treat burning or aching along the bottom of the foot. Poor internal support is especially problematic if you’re naturally flat-footed.
Strained soles.
Many casual flats have even less interior cushioning than heels or sandals. This lack of padding can trigger pain in the heel or ball of your foot when you’re walking, especially if you have high arches.
Fixes for Flat Shoes
Give your feet a workout.
To wear shoes with no built-in support, you need to strengthen the tiny foot muscles that support your arch. Try doing toe lifts: Raise your big toe without moving the rest of the gang. Until you get the knack, wiggle your toes and rub your feet vigorously, which will stimulate your nerve endings and help wake up your feet. Do 20 toe lifts per foot.
Stretch it out.
Just as the abductor/adductor machine at the gym strengthens your outer and inner thighs, you can work your toe abductors and adductors to make the muscles of your foot stronger and more supportive. Start by interlacing your fingers with your toes to help press them apart, then spread and relax them without assistance from your hands. Hold the stretch long enough to sing the alphabet. Do this once a day (or up to three times if you have bunions).
Bump it up.
Help strengthen the small muscles in your feet and lower legs by striding barefoot across an uneven surface such as cobblestones. This also helps stimulate the nerves in your feet. Buy a pre-made cobblestone mat with smooth stones already glued to it, or find (or make) a bumpy space to walk back and forth on in your backyard.
Add OTC insoles.
If you have flat feet (your wet footprint shows the entire foot), foam or rubber insoles can help prevent your arches from collapsing. If you have high arches (you see only the heel and ball of your foot in your footprint), look for an insole with more rigid arch support.
Shop smarter
Look for flats with an insole that curves along the same lines as your foot and arch. Then try to fold the shoe in half—it should bend only at the ball (the same place your foot naturally bends as you walk). Also avoid pairs that fold right in the middle or roll up easily.
How Toning Shoes Cause Foot Pain
Shoes with rounded or “rocker” soles that purportedly increase muscle activity and boost calorie burn are big business—after all, who doesn’t want to get a workout without really working out? But despite their medical provenance (rocker-bottom shoes were originally engineered to help patients with pain in the balls of the feet, says Leahy), consider the following before you get a pair as a fitness tool.
Stress case.
The rigid soles prevent arches from naturally flexing. Eventually, this can cause your arches to flatten and lead to overpronation (when the feet excessively roll in while walking). The result: Your feet absorb less shock, causing your knees and back to take on extra stress.
Relief from Rocker Shoes
Be inspired (but don’t skip your strength workout).
If these shoes help you feel more conscious of the benefits of every step you take and make you want to walk more, go for it! But don’t skip proven strengtheners. The best way to tone your lower body is with strength moves such as squats and lunges, not just walking around in toning shoes.
Contact The Podiatrist (www.thepodiatrist.co.nz)
CHOOSING the right pair of shoes for your child will ensure proper foot growth and bone health.
WALKING is a milestone in every child’s life, and often parents take it into a bragging right, comparing their child’s walking timeline to other kids’. In their minds, the earlier their child takes those tentative first steps, the better parents they are.
Between the ages of 12 and 18 months, children start to take their first steps. Every child is different, and the only way to go about it is to let them take the lead.
Another thing that parents need to be aware of is proper footwear for kids.
First shoes
When children can walk steadily (around 18 months old), they should wear “healthy” shoes with mild arch support.
When buying shoes for kids, parents need to reserve one finger’s spacing (i.e. 8-10mm). Most parents have a tendency to buy shoes that are way bigger than their child’s feet, in the hope that the child will grow into them. As kids’ feet grow fast, it is also one way of reducing the need to replace the shoes every six months. Lee says this should never be done.
Do not buy shoes that are too large. Excessive rubbing against the shoes when walking will lead to callus. Besides, since there is too much space between the shoes and their feet, children will try to hold onto their shoes with toes and this will lead to claw toes in the long term.
Foot problems
There are areas of concern that parents should pay attention to when considering footwear for their child.
Flatfoot is a common one, where the foot arch is flattened or fallen when standing, without the normal curve that it should have.
People with a flatfoot become tired and feel the pain easily when they walk. For serious cases, it will affect their knee joints and backbones.
Flatfoot is inborn or genetically linked in most people.
> Children below the age of four: There is a thick layer of fat beneath their feet covering the foot arch, which makes them look as if they have flatfoot. It can’t be determined yet if they really have flatfoot or not, until the layer of fat disappears gradually. Normally, the foot arch develops its shape between four and six years old.
> Children between four and 13 years old: Starting from the age of four, the layer of fat beneath their feet reduces steadily. Before the age of 14, their bones are still in developmental stage. So children with flatfoot could still be treated by using suitable arch inserts and going for regular exercises and a balanced diet to avoid getting fat. There is still room for improvement and it is possible to prevent long-term problems reccurring.
> Children aged above 14: Their bones mature after the age of 14. Although at this stage flatfoot is difficult to improve, it is still necessary to use suitable arch inserts and to do regular exercises to minimise long-term problems (caused by flatfoot).
When choosing the right shoes
> Some mothers believe they should look for shoes with arches for children under two. This can, in fact, interfere with their ability to walk.
> Each child has a unique walking pattern, but more than 40% of mothers do not realize this. Most would put their kids in hand-me-down shoes, especially from older siblings or cousins. This should not be encouraged.
Shoes worn by one child over a period of time would be worn in places depending on the walking pattern. When you put the same shoes on another child, who has a different walking pattern, the support and fit would be off. The child would be trying to form to the gait of another child.
> For the best fit, children’s feet need to be measured every two to three months until the age of two as foot growth is rapid during the first two years. After that, have regular checks every four to six months.
> Bones are not fully formed in a child’s foot until age five, therefore the cartilage can be easily influenced by ill-fitting footwear. It should also be noted that the feet grow right into your late teens, therefore your child’s 10th pair of shoes is just as important as the first one.
> Babies’ feet perspire two times more than adults’, so you should always look for breathable material like leather and mesh or anti-microbial linings.
They should opt for footwear with a hard heel counter, mild arch support and different sizes of toe box that are suitable for forefeet fat and thin.
For professional advice or help with a problem, see The Podiatrist.
Custom Tie Your Running Shoes
Custom Tie Your Running Shoes
Here are five ways to lace your running shoes and relieve that nagging foot pain.
You went to a running speciality store, tested out several models, and bought a pair that felt great. So why are your new running shoes rubbing you the wrong way? Even if you are fitted with a pair that suits your arch type and weekly mileage, your feet may have characteristics that make the seemingly perfect shoe less than comfortable over the long haul. Luckily, the solution could be as easy as relacing your shoes, says Richard Bouché, D.P.M., of the Sports Medicine Clinic in Seattle, who provided the techniques below. “Before you get a new shoe, try adjusting the lacing to enhance the fit,” Bouché says. “It’s a small change that can make a big difference.”
PROBLEM: “MY SHOE RUBS ONE SPOT ON THE TOP OF MY FOOT.”
Solution: Eliminate pressure on a “hot spot” by lacing around it, not directly over it.
Technique:
Place a lipstick smear on your hot spot. Slide your bare foot into your shoe and take it out. The mark on the underside of the tongue tells you which set(s) of eyelets to skip. Lace your shoe until you reach the eyelet before the spot. Take the lace back under and pull it up through the next eyelet on the same side. Take the lace across and continue to lace. Repeat this on the other side. You’ll have an empty spot on the tongue where no laces cross it, which should eliminate your pressure point.
PROBLEM: “MY BIG TOENAIL TURNED BLACK.”
Solution: Lift the upper material above your big toe up and off it.
Technique:
Thread one end of the lace through the eyelet next to your big toe. Pull the end of that lace up to the last eyelet on the opposite side, bringing the lace through to the outside. Leave just enough slack at the top to tie a bow. Take the remaining portion of the lace straight across toward the outside of the shoe and then diagonally up toward the inside of the shoe. Repeat until all of the eyelets are laced. When you tug on the outside lace, it will pull the material above your big toe up and off your nail.
PROBLEM: “MY SHOE IS TOO TIGHT ALONG THE TOP OF MY FOOT.”
Solution: Use parallel lacing to secure your foot without putting pressure on the top.
Technique:
Lace the first two eyelets on the big-toe side of the tongue (not the first eyelet on either side of the tongue like you normally would). Bring the lace from the first eyelet straight across to the first eyelet on the other side of the tongue and push it through. Pull it straight up the side, skipping one eyelet, and thread it through the third eyelet. Pull it straight across the tongue, and push it through the third eyelet on the opposite side. Repeat until all eyelets are laced and tied.
PROBLEM: “MY TOES FEEL CRAMPED.”
Solution: Reduce forefoot constriction by using four shoelaces instead of two.
Technique:
Remove the laces and measure them. Buy two sets (four laces) half that length. On both shoes, use one lace for the bottom three eyelets and a second lace for the upper three eyelets. The end result will be two bows on each shoe, allowing you to tie the bottom laces looser to accommodate your wider forefoot.
PROBLEM: “MY HEEL SLIDES UP AND DOWN.”
Solution: Create a more secure fit around the ankle without tightening the entire shoe.
Technique: Lace as normal until one eyelet remains on each side. Draw the lace straight up on the outside of the shoe and bring it through the last eyelet. This will create a loop. Repeat on the other side. Cross each lace over the tongue, thread it through the opposite loop, and tie. The loops help to cinch in the material around your ankle to prevent your heel from slipping without making the rest of your shoe any tighter.
PROBLEM: “MY HEEL SLIDES UP AND DOWN.”
Solution: Create a more secure fit around the ankle without tightening the entire shoe.
Technique: Lace as normal until one eyelet remains on each side. Draw the lace straight up on the outside of the shoe and bring it through the last eyelet. This will create a loop. Repeat on the other side. Cross each lace over the tongue, thread it through the opposite loop, and tie. The loops help to cinch in the material around your ankle to prevent your heel from slipping without making the rest of your shoe any tighter.
