Preventive medicine in the field of podiatric medicine is just as important to your child as it is in dentistry or general medicine. Many children walk excessively pigeon toed, flat footed, or bowlegged; although they are not in pain, they are damaging their feet and causing abnormal stress to all the joints of their lower extremities as well as their back.

Why do some children in-toe?

Most babies begin life with their toes pointed slightly outward. However, if the unborn baby lies with its feet pressed against the womb the wrong way, it can be born with its feet turned inward. The condition can make learning to walk difficult. Tripping and falling a lot may be the first sign of toeing in. Often, this can be corrected in the first few months of life, but delay causes the deformity to be more permanent. Bone abnormalities like metadductus (long bones in the foot growing inward) will also cause children to in-toe. This is treated with bracing but becomes more difficult as the child grows and the bones become less flexible.

In-toeing can often be corrected through stretching exercises in the first few months of life. Exercises also help older children in which the in-toeing comes from their hips being tight. The podiatrist or physical therapist can teach parents some simple exercises that can help straighten out a baby's feet. The exercises take a few minutes a day and they are performed until the problem is corrected.

In some instances, like metadductus, plaster casts or custom braces can be used to coax a baby's feet back into normal position. Just as braces gradually reposition teeth, casts gradually reposition feet. The casts or braces are changed periodically until the podiatrist determines that the feet are properly aligned.

Some children in-toeing is not just due to a foot problem, but can be related to a hip and leg problems which they will not outgrow. The best advice is: if you notice your child excessively in-toes or has trouble tripping and falling; contact the office for a full pediatric biomechanical exam. There is help for most gait abnormalities.

Are flat feet normal?

Many babies naturally appear flatfooted. Usually, this will disappear as the baby begins to stand and walk. Some children do not grow out of this deformity and have trouble as they grow. Children with flat feet, or low arches, may not be able to keep up with other children because of the added strain on feet and legs. If you notice your child is having trouble running and is flat footed, don't assume they will "grow out of it!" Most kids don't. Bring them in for a biomechanical exam. Some flat foot problems can be treated similar to intoeing with bracing, casting and exercises. Often an orthotic device can help your child function better.

Do orthotics help children?

Orthotic devices can be used to maintain proper foot alignment and support. They are made of plastic and must be refitted as the child grows older. Usually they are good for two shoe sizes or 50 lbs of growth. In younger children, these often need to be refabricated at least once a year.

Orthotics are a custom in-shoe foot brace that align the child's lower extremity and helps them to grow straighter. Many deformities and gait abnormalities can be accommodated with orthotics, but unless very early intervention at just a few months old is sought; the orthotic does not make the deformity go away but allows better overall function; think of an orthotic as eyeglasses for your feet. Orthotics help to distribute body weight evenly and realign the foot. They can slow down the progression of many inherited foot deformities and help children's feet grow more properly. They also decrease the associated biomechanically induced problems seen at the knees, hips and lower back.

When should you bring your child to see a doctor?

If you suspect any foot problems, have a podiatrist who has experience in childhood foot problems examine your child. Remember that proper care and treatment of the feet in childhood will often prevent many of the orthopedic foot and ankle problems seen in adults.

Have your child's feet examined by an experienced podiatrist specializing in biomechanics in children. You may spare your child further suffering later in life!