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