Introduction to biomechanics


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Flatfeet in Children: When Are They A Problem?

There are high arch feet and low archshows any of these signs it is necessary
feet and many different foot types into visit a podiatrist to be evaluated.
between. Many individuals have flatfeet,In many cases, small problems that are
but do not have foot problems. All of usdeveloping in this age group can lead to
are born with flatfeet and some of themore severe problems down the road.
greatest athletes have flatfeet. But,Generalized ankle pain is the most
flatfeet are a problem when the archcommon complaint in children this age
completely collapses in combination withwith flatfeet. Typically, they will be
excess inward rotation in the foot. Thisable to run and play sports, but find
type of flatfoot causes excess stress onthat they have a deep, achy pain in and
the joints, ligaments and tendons in thearound their ankle when they are done.
foot and ankle. If not treatedChildren this age have a very difficult
appropriately, tendon and joint problemstime expressing the type of pain they
will develop.Flatfeet are normal inare experiencing and when they
infants and the arch will not start toexperience it. Writing down when the
develop until between four and eightpain happens and where is occurs will
years of age. Up until this time, allhelp your doctor during the visit.Over
children will have flatfeet. Manyfourteen years of age, the growth slows
children under the age of 4 may havein girls and over the next few years the
excessively flatfeet and excess rotationgrowth plates in the feet fuse. Boys
in their feet. How do you tell thewill have continued growth until 16 to
difference? The following list may18 years of age. Children in this age
indicate that your toddler's flatfeetgroup will typically complain of pain.
are a problem:1. Your child is over 15The most common problem in children with
months of age and has not startedflatfeet in this age group is
walking.2. Your child started walkingtendonitis. The pain is either at the
around 12 months but seems to preferback of the heel, or at the inside of
crawling.3. Your child is between thethe arch. Sometimes the foot and ankle
ages of 2-4 and complains of foot painare stiff and sore in the morning, when
or leg pain. In many instances, this legfirst stepping down. Walking up and down
pain is confused with growing pains.4.stairs or hills, squatting or walking on
The wear on your child's shoe isuneven surfaces will cause more pain in
uneven.5. Your child's arch is touchingthese tendons.Treatment of tendonitis
the ground and the ankles look like theyinvolves rest, ice and immobilization
are rolling in, bringing the kneesfor a minimum of two weeks, but two
together.For toddlers, the typicalmonths can be a common recovery time.
treatment is a kiddie orthotic. This isWhen these conditions develop as a
a pre-made orthotic which comes inresult of flatfeet, it is necessary to
different sizes. It will fit into any ofbe fit with orthotics to prevent the
your child's shoes and should beproblem from occurring again. Not every
comfortable for them. This will helpfoot needs a custom made orthotic. There
stabilize their foot while they areare many prefabricated orthotics that
walking. In severe cases, or in childrenwork well. A prefabricated orthotic is
ages 3 and 4, a custom made orthotic maynot the same as an insert. An insert
be necessary. A custom made orthotic isslips into the shoe and will provide
a device that involves taking a mold ofcomfort, cushion and a little support.
the foot, typically done with plaster,In some cases, inserts purchased at the
but sometimes done with foam. A devicedrugstore will help alleviate some arch
is made with specific corrections foror heel pain and give relief to sore,
your child's foot and looks like atired feet. But, an insert is not an
plastic insert. This insert can sliporthotic. Orthotics are devices which
into the shoe and can be switched fromfit into the shoe and aid in foot
shoe to shoe.Children can wear the samefunction.The most important difference
insert for up to 2 shoe sizes, then ais an orthotic controls abnormal motion
new pair must be made. Although theand corrects foot function, while an
insert will not change the way the footinsert will only provide cushion and
develops, it will support the foot andcomfort. Pre-fabricated orthotics can be
allow for a more normal walking pattern.found at your local sports store and
In some cases, children only need thewill help many individuals with
orthotic during the first few years, andflatfeet. They are much cheaper than
after the arch develops, the orthotic iscustom-made orthotics, but they will
no longer needed. In most cases,wear out in 1-2 years. A custom-made
children will not "outgrow" theirorthotic is custom to each foot and
flatfeet.As the arch develops between 4corrections are built-in to help the
and 8 years of age, the child's bodyfoot function. They are designed to keep
goes through numerous changes. The bonesstress off the ligaments and tendons in
grow in length while the leg and thighthe arch and designed to distribute the
bones are rotating. During these yearspressure evenly while walking. The cover
it may be difficult to determine if thematerial on the custom-made orthotic may
flatfeet will become a problem or not.need to be changed every one to two
One of best indicators of a problem isyears, but the orthotic itself will last
pain. Children should not have pain inten years. As expected, custom-made
their feet. They should be able to runorthotics are much more expensive than
around with their friends or in anprefabricated orthotics or inserts.In
organized sport without any pain. Ifsummary, all infants have flatfeet, but
your child is having foot, ankle or legmore severe flatfeet in this group can
pain, make sure they see abecome a problem. The arch develops
podiatrist.Young children between eightbetween four and eight years of age and
and thirteen years may have flatfeet,predicting long term foot problems in
but not complain of any pain. This is athis group can be difficult. Many
common occurrence in this age group,children, teenagers and adults have
especially if the children are notflatfeet, yet no foot problems.
competitive in any sports. Look for theTherefore, not all flatfeet need to be
following:1. The arch touches the floortreated. But, children with foot, ankle
and the ankles and feet rotate in.2. Theor leg pain and flatfeet should be
knees are very close togetherevaluated by a podiatrist. For children
(knock-knees).3. Shoes are worn outwith flatfeet and foot pain, custom made
within 3 months.4. Wear pattern on theorthotics are essential to treatment of
shoe is toward the inside (big toethe foot problem and for prevention of
side).5. Your child's gait is bouncy orproblems in the future.Christine
looks awkward.6. Your child seems slowerDobrowolski is a podiatrist and the
than his or her friends or shows a lackauthor of Those Aching Feet: Your Guide
of interest in sporting activitiesto Diagnosis and Treatment of Common
despite being athletic.If your childFoot Problems. To learn more about Dr.



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