Down Syndrome

Down syndrome is one of the most common genetic disorders and is thought to affect 1 baby in every 700 births. People with Down Syndrome had varying developmental delays and medical concerns often of the heart, stomach, eyes, bones and joints. These may affect movement and coordination and can progress later in life.

The move common defining foot and gait features include:

• Smaller or shorter limbs, fingers, hands, toes and feet
• Low muscle tone and loose ligaments
• Broad feet with a deep plantar crease (skin crease running down the underside of the foot)
• Flat ‘pronated’ feet with a low arch height
• Decreased ankle joint range of motion
• Wide base of gait and support w
• Excessive external hip rotation with feet pointed outwards
• Tendency to walk on toes
• Poor foot clearance during swing phase causing the tendency to scuff the foot and trip
• Poor balance

In relation to feet the combination of ligamentous laxity (loose ligaments) and low muscle tone contribute to the orthopedic problems seen frequently in people with Down Syndrome which often become evident as children are learning to walk. This is largely where podiatric intervention can play a role in aiding mobilisation with lower-limb development and control.

The most common foot and leg conditions include:
1. Hallux Abducto-Valgus (bunions)
2. Plantar Fasciitis (pain in the arch)
3. Anterior knee pain related to flat ‘pronated’ feet
4. Clawing of the toes
5. Calluses and corns and associated ingrown toenails
6. Shoe irritation (generally from footwear with insufficient width)

There are a number of things which can be done to assist with treatment of any of the above conditions non surgically from physical therapy or assistive devices such as splints or orthotic therapy and treatment pathways will be formulated with patients and their family according to their goals and values.