Flat Feet: The most common pediatric foot problem.
Over-pronation, or flat feet, is a frequent cause of medical visits for pediatric foot problems. A diagnosis of flat feet is further divided into flexible and rigid flatfoot, and the management and treatment differ according to the diagnosis. In this case of medical terminology, the name implies exactly what the diagnosis is.
- In rigid flatfoot, the bones are stiff, and neither the bones nor the joints move very well, and in some cases, do not move at all. They are “stuck” in a flattened (collapsed arch) position.
- Flexible flatfoot is a condition where the arch has also fallen or is in the process of falling, but the bones and joints are still mostly flexible and can move around.
Most pediatric flexible flatfeet are physiological, mild, and have no symptoms, and may require no special treatment other than properly fitted, good quality shoes. However, if symptoms are present in flexible flatfeet, then treatment should be considered. In our office, we correct flexible flatfoot. Initial treatment options include a possible modification of physical activities, properly fitting shoes, physical therapy, and possible orthotic support.
How is pediatric flatfoot diagnosed?
At Ravenswood Chiropractic & Wellness Center our chiropractor diagnoses pediatric flatfoot by visual assessment, which includes a general examination of the child’s musculoskeletal system, walking pattern, as well as the specific foot and ankle examination. There are many methods currently used to identify a medial longitudinal arch (MLA) problem, but the footprint method is still the most popular method used to analyze and assess the MLA.
Symptomatic Pediatric flatfoot is characterized by a low MLA and requires treatment. A child with no symptoms, but who is obese, as well as a child with genetic abnormalities, should also be assessed for treatment.
What kind of treatment is recommended?
There is no consensus of a set treatment protocol for all children. Each child needs to be individually assessed, and in addition to chiropractic intervention for biomechanical causes, as well as physical therapy, treatment could take the form of supportive custom, or semi-custom orthotic insert options for the child’s footwear.
Some things to consider:
- The age of your child. An arch in a child’s foot is not yet developed until between the ages 2 and 3. Before then, a child’s foot will look different to an adult’s foot. Some pediatricians do not recommend treatment for flatfoot until the age of 5 years, as many developmental changes continue to take place before the age of 5. Others argue that if there is a visual, obvious problem, it is more important to intervene earlier. Since every situation is different, we can discuss with you what options may work best for your child.
- Muscle tone of your child. We will determine if your child has normal, high, or low muscle tone. Depending on the outcome, you will be directed to the appropriate type of therapy if it is deemed necessary.
- The strength of your child’s feet and ankles. We will do some non-invasive orthopedic tests to establish whether or not the standing tolerance is good or bad. If it is bad, we will investigate the causes, and develop a plan of correction.
- Physical abilities of your child. If your child has difficulty completing motor skills then considering treatments such as physical therapy, orthotics, or chiropractic care that enable development and completion of the task unhindered by biomechanical imbalances is advised, and we will review your options with you.
A correctly fitted, high-quality shoe may provide excellent support for your child’s feet and ankles, especially if there are no biomechanical deficiencies or only mild flatfoot. If flatfoot is more pronounced or symptomatic, custom orthotics may be deemed necessary. We would then be able to provide custom made orthoses, calibrated by the biomechanical needs of the child, which will be the most beneficial.
Each child presents a unique clinical situation, and an orthotic for your child will be a unique custom device made to ensure the best possible results.
Sole Supports Outgrowth Policy
Children grow and develop rapidly, and as a result, their biomechanical needs and orthotic prescriptions may change at the same pace. We appreciate that your child’s health is important to you, and to assist with what could be a frequent financial outlay, we offer an industry-leading outgrowth policy available with your child’s orthotics. This renewable policy allows for the purchase of additional orthotics as your child grows, at significantly reduced prices.
Contact us for more details.
The clinical goal of orthotic treatment
The purpose of a prescribed orthotic device is to reduce pain and deformity associated with pediatric flatfoot, by reducing excessive strain on the MLA, and providing the necessary support. It is essential that the child receives the best possible outcome to promote his or her development.
For more info about pediatric foot orthotics call and speak to one of our expert team members today or schedule an appointment online.
- Bleck, EE; Berzins UJ, Conservation Management of Pes Valgus with plantarflexed talus flexible. Clin. Orthop. Relat. Res. 1977; (122):85-94
- Bordelon, RL, Correction of Hypermobile Flatfoot in Children by Molded Insert. Foot and Ankle. 1980; 1(3):143-150.