Most of the time we are overly alarmed by the way our children walk or step. We have to keep in mind that they are not miniature adults, but people who are in a growing phase. Just this situation, which is also changeable, makes us sometimes observe gestures and postures that make us worry about whether they will persist as adults.
Most of the time, their age-related laxity is responsible for those foot positions that appear to be what they are not, they are not all flat feet. And certainly their tendency will be to evolve favorably without any treatment.
But as there are always limits, that position of feet and legs can exceed the physiological and need help, so it should be assessed by a professional podiatrist.
In any case, if you have your little one stand on tiptoe and you see that the heels, which when standing “went inward” (in valgus), are not placed in an inverted or neutral position when standing on tiptoe, it could be an indication that help is needed to ensure growth without misaligned loads that may hinder it.
If, when checking their footwear, you see asymmetrical sole wear, or excessive wear on one side of the heel, or you see that, looking at the shoe from front to back, its shape has changed, it could also be an indication that you should try to help them.
When and why is it important to see a specialist with our children?
Under certain circumstances it is important to take our children to the podiatrist:
- Of course, if pain appears, with the consequent limitation that it will produce in their day to day life.
- If your weight and, therefore, the force that will support that foot is excessive, it could enhance postural abnormalities that would hinder normal walking.
- If he falls frequently.
- If he lacks agility which, at the same time, hinders integration with the group.
- If he/she plays impact sports with high frequency.
- If the knees are too close together or the feet are tucked in.
On the other hand, it is important to emphasize that genetics conditions but strength determines. In this case, the force will be generated by the weight and speed that, together with a laxity that deviates the feet, could alter the growth. If we add to this the fact that, nowadays, the sports load in children is not small, one of the frequent reasons for consultation occurs: injuries and deformities that would be more typical of adult ages.
However, depending on the age, the normal values in all the postures mentioned above are changeable.
Could the abnormalities in children’s stepping and walking be transient?
Yes, they are. As we mentioned before, in most of the cases that come to consultation, these are physiological postures, and the problem is that we compare them with those of an adult. Without doing anything complementary, except for controls to confirm that the evolution is positive, it is enough. A first study is always vital to be able to have a comparative history and see what values we are starting from.
How to correct problems such as pronation, hyperpronation or supination?
Some movements such as supination and pronation are necessary for the child’s foot to develop its adaptive function normally. However, always within certain limits.
In order to give more consistency to the passive structures, such as joint capsules and ligaments, we opted for plantar supports, intended to resemble as much as possible, by their consistency and elasticity, to what would be normal in a foot. Mainly, the materials we use to achieve this is the 3D printing of polyamide powder.
For the active structures responsible for the stability of the foot, such as the muscles, we offer exercises masked in games in order to be better accepted by the children.
Are other problems such as tipping the toes inward when walking, or, on the contrary, outward, correctable?
It is a bit like the situation we mentioned before, those changes of posture in the position of the foot is not exclusive of this one, the hips grow and also structures are repositioned, so certainly one influences the other. That is to say, an advanced hip will generate that the knees rotate internally and the foot sinks, but it is that it can happen the opposite, a little functional foot when sinking provokes an ascending injury chain.
But, except for exceptions that will need more drastic treatments, most of them evolve favorably as we approach the phase of bone maturation. In any case, we can always help ourselves, not only with insoles to control this adduction or abduction of the foot, but also with a whole arsenal of exercises to control possible motor deficits and compensate for them.