Blog Archives

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.
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.
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.
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


Movement, Co-ordination and your 1-2 year old

baby walking

Walking is the major achievement of kids this age and over the course of the year they’ll get much better at it.
As kids’ mobility improves, so does their ability to investigate where they couldn’t before. Once again, take a look around your home from a kid’s vantage point and update childproofing measures to keep pace with your child’s advancing skills.
How Is My Baby Moving?
Though some babies take their first steps before their first birthdays, most children learn to walk well in the months after they turn 1.
Kids who are learning to walk are called “toddlers” because that’s exactly what they do — they toddle, keeping their legs wide apart and seeming to hesitate between each step, jerking from side to side as they move one foot forward, then the next.
About 6 months after taking the first steps, toddlers develop a more mature gait, holding their hands at their sides (rather than out in front for balance) and moving with their feet closer together. They also tend to move their feet in a way that looks more like walking — moving from the heel to the toe.
During these months of practice, most toddlers take a few spills, but this is part of learning to walk. You can’t protect your youngster from every fall, but you can reduce the risk of injury by keeping exploration in areas with soft carpeted surfaces and away from sharp corners of furniture.
To get back up from a fall, toddlers often place their hands out in front, lift up their bottom, and then pull their feet under. It may not look very graceful, but it works.
After walking for a couple of months, your child will begin to feel more confident about walking and take on new challenges — such as picking up and carrying objects, moving while pulling a toy behind, and climbing stairs.
By the middle of the second year, your child may learn to run, start to kick a ball, and even attempt to throw a ball overhand. By 2 years, your child may jump in place.
As kids develop the ability to move, they’re also learning. You’ll notice that your child seems extremely interested in finding out how things work, so offer safe opportunities to do this.
Helping Your Child’s Development
Give your child lots of things to do and see in this new upright position. Take walks around your yard or through the neighborhood together or hold hands and climb up and down the stairs together. You can even make an obstacle course of pillows or boxes and encourage your child to walk, climb, and crawl through it. Buy a few balls for kicking and throwing.
Experts recommend that toddlers should:
accumulate at least 30 minutes daily of structured physical activity like playing on the playground, going for a walk, or being in a parent-and-child tumbling class
also have at least 1 hour of unstructured free play each day when they can explore and play with toys
not be sedentary for more than 60 minutes at a time, except while they’re sleeping
have indoor and outdoor areas that meet or exceed recommended safety standards for all of their activities
As their physical skills develop, toddlers also learn to use their hands more. Toys and objects that can encourage this include:
paper and crayons
sculpting dough
simple stacking toys that kids can build up and knock down
simple puzzles
When to Call The Podiatrist
Normal child development follows a certain pattern, and the skills that babies develop early are building blocks for later skills. But the time it takes for kids to develop them can vary widely.
See The Podiatrist if you child is having problems:
walk by 18 months
walk in a more mature pattern after several months of practice
walk any way but on the toes
climb stairs while holding on

Good children’s foot care makes the pitter-patter of little feet stronger

Strong, healthy feet begin in childhood where early recognition and management of foot problems will prevent medical and structural problems later in life.

Unless a child has an obvious deformity or troublesome foot issue there is a good chance that his or her foot problem will be overlooked. Children’s feet are an important part of an overall developmental process. Any abnormalities within the feet will affect the general posture, causing changes within the skeletal structure. Some common children’s foot conditions are: flat feet, in-toe and out-toe walking and toe walking with the heels not touching the ground.

Sometimes the bone of the upper or lower leg is slightly twisted, a condition that may have a family history. If the leg bone is twisted inwards, the child may walk with toes-in and conversely if the bone is twisted outwards the walk is toes-out. A short or tight Achilles tendon is the most common cause when a child walks on tiptoes only. This condition could also be neurologically based so it is important that the child have a development assessment. Flat feet is a common foot condition characterized by an abnormally low or absent medial longitudinal arch, especially on weight bearing. It is normal for infants and toddlers to have low arches but they should be observed for any abnormal in-toeing, out-toeing or, excessive limping. Kids who over pronate often complain of night cramps, shin splints or heel pain.

For a proper assessment take your child to Kidsnmotion Podiatrists. Treatments usually consist of monitoring, exercises, activity alteration, orthotics, splints, braces, footwear,

Warning signs that your child should have a foot check-up: shoe wear is uneven, lumps or bumps are evident on the feet, pain in the feet, heel or leg, excessive tripping or falling, visible skin or toenail problems.

For more information make an appointment today

Things you should know about flat feet.

Q: What causes flat feet? Is it a common condition?

A: Flat feet are a common condition, estimated to occur in approximately 20 to 30 percent of the population. There are many reasons why an individual may have a flat-foot condition.

First, there may be a rare congenital defect, which is present at birth, such as vertical talus, which manifests as a rigid rocker-bottom flat foot. But, generally, most infants and toddlers do have flat feet because the arch structure has not yet developed. The development of the arch normally occurs during early childhood after 3 years of age.

In the 10- to 14-year-old range, a cause may be a condition called tarsal coalition. This is an abnormal connection between two bones in the foot which leads to a painful, spasticity (stiffness) of the peroneal tendon.

As we age, there are many reasons why an individual may develop a flattening of the arch, which is known as an acquired flat foot. These causes are developmental and include:

  • Connective tissue disorders, such as rheumatoid arthritis.
  • Endocrine disorders such as diabetes mellitus.
  • Osteoarthritis.
  • Tight Achilles tendon.
  • Dysfunction of the posterior tibial tendon; when the tendon on the inside of the ankle loses its functionality.
  • Obesity.
  • Aging.
  • Trauma.

Finally, the hereditary or genetic predisposition to a flat foot is also a possible cause.

Q: What symptoms might someone with flat feet experience?

A: Symptoms are varied and depend upon the cause of the flat foot, the individual’s activity level and the type of footwear that is worn. An individual may present to the office with heel or arch pain (plantar fasciitis), Achilles tendinitis, pain in the subtalar joint or ankle discomfort. Patients will often have several symptomatic areas, have difficulty with exercise, and may even have knee, hip or back pain.

Q: When should someone with flat feet see a Podiatrist?

A: Typically a patient will not seek professional treatment unless they are symptomatic, except for those times when a parent may be concerned with their child’s foot structure or function. The question arises: If someone has a flat foot will they be symptomatic or develop problems later in life? The answer to this is, not everyone will develop issues later on. With that being said, medical treatment should be sought if one is symptomatic with pain or if the flat foot condition is severe (a significant rolling inward of the foot and ankle during walking).

Additionally, if one has noticed a change in their foot structure such as a sudden collapse of the arch or has a medical condition with decreased sensation
to their feet (such as in diabetes mellitus), there are sufficient studies that show the initial evaluation and periodic follow-ups with a podiatrist may help
prevent further complications.
Q: What are some easy solutions that people can try?

A: Wearing well structured shoes and sandals that provide adequate support to the arch structure of the foot. It is important to understand that one size does not fit all. Some flat foot cases may require custom-made orthotics, an ankle/foot brace, special shoes and in extreme cases, surgery.

Q: When is surgery necessary for flat feet?

A: Surgery is an alternative when conservative measures have not provided a satisfactory relief from pain and discomfort. Additionally, patients who are at risk for chronic breakdown or ulcerations on the bottom of their feet due to the complete loss of the arch structure are good candidates for surgical intervention to prevent further complications. For the most part, however, conservative and non-surgical treatment plans will be effective in the majority of cases.