| There are high arch feet and low arch | | | | shows any of these signs it is necessary |
| feet and many different foot types in | | | | to 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 us | | | | developing in this age group can lead to |
| are born with flatfeet and some of the | | | | more severe problems down the road. |
| greatest athletes have flatfeet. But, | | | | Generalized ankle pain is the most |
| flatfeet are a problem when the arch | | | | common complaint in children this age |
| completely collapses in combination with | | | | with flatfeet. Typically, they will be |
| excess inward rotation in the foot. This | | | | able to run and play sports, but find |
| type of flatfoot causes excess stress on | | | | that they have a deep, achy pain in and |
| the joints, ligaments and tendons in the | | | | around their ankle when they are done. |
| foot and ankle. If not treated | | | | Children this age have a very difficult |
| appropriately, tendon and joint problems | | | | time expressing the type of pain they |
| will develop.Flatfeet are normal in | | | | are experiencing and when they |
| infants and the arch will not start to | | | | experience it. Writing down when the |
| develop until between four and eight | | | | pain happens and where is occurs will |
| years of age. Up until this time, all | | | | help your doctor during the visit.Over |
| children will have flatfeet. Many | | | | fourteen years of age, the growth slows |
| children under the age of 4 may have | | | | in girls and over the next few years the |
| excessively flatfeet and excess rotation | | | | growth plates in the feet fuse. Boys |
| in their feet. How do you tell the | | | | will have continued growth until 16 to |
| difference? The following list may | | | | 18 years of age. Children in this age |
| indicate that your toddler's flatfeet | | | | group will typically complain of pain. |
| are a problem:1. Your child is over 15 | | | | The most common problem in children with |
| months of age and has not started | | | | flatfeet in this age group is |
| walking.2. Your child started walking | | | | tendonitis. The pain is either at the |
| around 12 months but seems to prefer | | | | back of the heel, or at the inside of |
| crawling.3. Your child is between the | | | | the arch. Sometimes the foot and ankle |
| ages of 2-4 and complains of foot pain | | | | are stiff and sore in the morning, when |
| or leg pain. In many instances, this leg | | | | first 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 is | | | | uneven surfaces will cause more pain in |
| uneven.5. Your child's arch is touching | | | | these tendons.Treatment of tendonitis |
| the ground and the ankles look like they | | | | involves rest, ice and immobilization |
| are rolling in, bringing the knees | | | | for a minimum of two weeks, but two |
| together.For toddlers, the typical | | | | months can be a common recovery time. |
| treatment is a kiddie orthotic. This is | | | | When these conditions develop as a |
| a pre-made orthotic which comes in | | | | result of flatfeet, it is necessary to |
| different sizes. It will fit into any of | | | | be fit with orthotics to prevent the |
| your child's shoes and should be | | | | problem from occurring again. Not every |
| comfortable for them. This will help | | | | foot needs a custom made orthotic. There |
| stabilize their foot while they are | | | | are many prefabricated orthotics that |
| walking. In severe cases, or in children | | | | work well. A prefabricated orthotic is |
| ages 3 and 4, a custom made orthotic may | | | | not the same as an insert. An insert |
| be necessary. A custom made orthotic is | | | | slips into the shoe and will provide |
| a device that involves taking a mold of | | | | comfort, cushion and a little support. |
| the foot, typically done with plaster, | | | | In some cases, inserts purchased at the |
| but sometimes done with foam. A device | | | | drugstore will help alleviate some arch |
| is made with specific corrections for | | | | or heel pain and give relief to sore, |
| your child's foot and looks like a | | | | tired feet. But, an insert is not an |
| plastic insert. This insert can slip | | | | orthotic. Orthotics are devices which |
| into the shoe and can be switched from | | | | fit into the shoe and aid in foot |
| shoe to shoe.Children can wear the same | | | | function.The most important difference |
| insert for up to 2 shoe sizes, then a | | | | is an orthotic controls abnormal motion |
| new pair must be made. Although the | | | | and corrects foot function, while an |
| insert will not change the way the foot | | | | insert will only provide cushion and |
| develops, it will support the foot and | | | | comfort. 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 the | | | | will help many individuals with |
| orthotic during the first few years, and | | | | flatfeet. They are much cheaper than |
| after the arch develops, the orthotic is | | | | custom-made orthotics, but they will |
| no longer needed. In most cases, | | | | wear out in 1-2 years. A custom-made |
| children will not "outgrow" their | | | | orthotic is custom to each foot and |
| flatfeet.As the arch develops between 4 | | | | corrections are built-in to help the |
| and 8 years of age, the child's body | | | | foot function. They are designed to keep |
| goes through numerous changes. The bones | | | | stress off the ligaments and tendons in |
| grow in length while the leg and thigh | | | | the arch and designed to distribute the |
| bones are rotating. During these years | | | | pressure evenly while walking. The cover |
| it may be difficult to determine if the | | | | material 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 is | | | | years, but the orthotic itself will last |
| pain. Children should not have pain in | | | | ten years. As expected, custom-made |
| their feet. They should be able to run | | | | orthotics are much more expensive than |
| around with their friends or in an | | | | prefabricated orthotics or inserts.In |
| organized sport without any pain. If | | | | summary, all infants have flatfeet, but |
| your child is having foot, ankle or leg | | | | more severe flatfeet in this group can |
| pain, make sure they see a | | | | become a problem. The arch develops |
| podiatrist.Young children between eight | | | | between 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 a | | | | this group can be difficult. Many |
| common occurrence in this age group, | | | | children, teenagers and adults have |
| especially if the children are not | | | | flatfeet, yet no foot problems. |
| competitive in any sports. Look for the | | | | Therefore, not all flatfeet need to be |
| following:1. The arch touches the floor | | | | treated. But, children with foot, ankle |
| and the ankles and feet rotate in.2. The | | | | or leg pain and flatfeet should be |
| knees are very close together | | | | evaluated by a podiatrist. For children |
| (knock-knees).3. Shoes are worn out | | | | with flatfeet and foot pain, custom made |
| within 3 months.4. Wear pattern on the | | | | orthotics are essential to treatment of |
| shoe is toward the inside (big toe | | | | the foot problem and for prevention of |
| side).5. Your child's gait is bouncy or | | | | problems in the future.Christine |
| looks awkward.6. Your child seems slower | | | | Dobrowolski is a podiatrist and the |
| than his or her friends or shows a lack | | | | author of Those Aching Feet: Your Guide |
| of interest in sporting activities | | | | to Diagnosis and Treatment of Common |
| despite being athletic.If your child | | | | Foot Problems. To learn more about Dr. |