Pediatric Flat Feet
OVERVIEW
Similar to in adults, flat feet, or over pronation, is a common biomechanical problem that occurs in the walking process when a person’s arch collapses upon weight bearing. Pronation refers specifically to the natural inward flexing motion of the arch and ankle. Running, walking and standing cause the ankle joint to pronate which helps the body to absorb shock and control balance. This motion can cause extreme stress or inflammation of the plantar fascia, possibly causing severe discomfort and leading to other foot problems.
There are many causes of flat feet, including:
- Obesity
- Tendon dysfunction
- Genetics
- Repetitive pounding on hard surfaces.
Children with flat feet often do not experience discomfort immediately and some never suffer any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves.
To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:
- Thorough history
- Strength and range of motion testing
- Biomechanical and gait assessment
- Evaluation of work, leisure activities and training programs that may exacerbate the condition
- Evaluation of footwear
- Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).
TREATMENT
Treatment for flat feet includes:
- Custom made foot orthotics
- Over-the-counter orthotics
- Arch support and/or
- Medial rearfoot posting
- Supportive footwear with a firm heel counter.
The treatment pathway is devised by the goals of pain reduction, pant management and to promote mobility and is adjusted according to the goals of the individual.
Club Foot
OVERVIEW
A type of flat feet is known as Club Foot. Clubfoot is a foot deformity where the arch collapses and is classified into three different types- idiopathic (unknown cause), neurogenic (caused by the nervous system) or syndromic (related to an underlying condition).
Idiopathic Clubfoot
Known as talipes equinovarus, idiopathic clubfoot is the most common type of clubfoot and is present at birth and is seen in one in every 1000 babies with over half of the cases seen involving only one foot, and is seen more frequently in boys compared to girls.
Neurogenic Clubfoot
This type of club foot is caused by the nervous system with an underlying neurological condition such as spina bifida at birth or may occur later in childhood due to spinal chord compression or cerebral palsy.
Syndromic Clubfoot
The final type of clubfoot is syndromic clubfoot, which is found along with a number of other clinical conditions which are the cause of the club foot such as diastrophic dwarfism and arthrogryposis (joint contracture).
For further readint on Talipes please click here.
TREATMENT
Treatment is often coordinated by your pediatrician however your podiatrist will work closely with them.
Treatment club foot includes:
- Surgery
- Stretching and casting
- Custom made foot orthotics
- Supportive footwear with a firm heel counter.
The treatment pathway is devised by the goals of pain reduction, pant management and to promote mobility and is adjusted according to the goals of the individual.
High Arched Foot
OVERVIEW
Opposite to flat arched foot, high arched feet instead of rolling in, the arch remains a high and curved arch putting more weight through the outside of ones foot. Frequently this foot is rigid in nature and lacks shock absorbing properties and creates secondary shin, knee, heel and back pain. These feet are often inherited or can be from a neurological diseases like Charcot Marie Tooth Syndrome.
TREATMENT
Often this type of foot will occur without pain and doesn’t require treatment, however when pain, discomfort or other problems arise, treatment is often indicated, and will depend on the symptomology and your personal goals. Treatment plans may include one or a combination of the following:
- Custom made foot orthotics
- Over-the-counter orthotics
- Footwear advice
- Stretching tight muscle groups
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