If my child steps on the inside, what should I do? It’s as if his feet are crooked, several people have told me that. Where should I take him to get it checked out?
Well, this problem is called flat feet, a very famous pathology, since everyone has someone they know with flat feet. What this causes is difficulty in walking, running, etc., due to the lack of arch in the feet, as the name itself indicates.
In this sense, there are two types of flat feet:
- Flexible flat feet.
- Rigid flat feet.
And another factor to take into account is age. For example, it is normal for a 2 year old child to have flat feet (flexible), in fact 80% have them at that age, but at 6 years old only 20% of children still have flat feet. Usually, with the years this problem disappears, although sometimes a few people with flat feet persist at the age of 7 – 8 years.
To know what to do with flat feet at the age of 6-8 years, it is necessary to consider whether they are flexible or rigid flat feet. The ankle moves the foot up and down in relation to the tibia. But the foot also moves inward (like clapping the soles of the feet) and outward. This inward and outward movement is made at a joint within the foot itself, the subtalar joint. To properly assess the flatfoot we need to see how they move on those two hinges.
The ankle must be able to go upward at least 20º or 30º (bring the toes to touch the tibia). This movement is pure ankle movement, i.e. the foot moves over the tibia. The other, that of the foot inward or outward, must allow us to walk on uneven ground, on an inclined plane such as a beach or an embankment. And it usually goes a little more inwards than outwards (the feet move more towards clapping with the soles of the feet than outwards).
So, what is the implication? Let’s go back to the shock absorber: if you go on a trip in a small car with 5 friends loaded with luggage, from the outside you can imagine how loaded the car will look when you see the rear shock absorbers very low, as if the car were touching the ground. But the car has shock absorbers, used to almost full travel, but it has them. The flexible flat foot has shocks, but it uses them all the way down and seems to collapse. The rigid flatfoot simply doesn’t have them and is always collapsing. Which car would you prefer to ride in on a bumpy road? If you ride in the one with shocks you will ride better than the one without. That’s why if the flatfoot is stiff it has a tendency to give pain when they are used a lot. You are more likely to have stiff flat feet than flexible flat feet.
Finally, we haven’t mentioned valgus feet. They are really the same thing. They are called flat if you look at them from the inside and don’t see the arch and they are called valgus when you look at them from behind and see how the heel turns outward and the ankle rolls over as if to touch the ground.
Finally, we will treat the feet that produce pain. It will be the traumatologist who will assess whether surgery is necessary, the physiotherapist to improve with stretching or the podiatrist for treatment with insoles.