Saturday, January 7, 2012

Fancy feet

If you’ve got a toddler with pigeon toes, flat feet or some other foot condition, it may go away on its own, but sometimes treatment is needed
My youngest daughter is almost 19 months old, but for the past few months I’ve noticed that the way she walks is different to her older sister.
She started walking at around 13 months of age, but it’s clear now that she walks pigeon-toed, also called intoeing.
So I’ve spent many hours reading about feet and I’ll try to condense it here for you as a quick guide to common foot problems in children.
The foot is quite a complex structure of 26 bones and 35 joints, and a baby’s foot is padded with fat and is highly flexible.
Foot conditions that your child may exhibit in their first years of life are flat feet, clubfoot, walking on their toes, feet turning outwards or inwards, bowlegs and knock-knees.
Clubfoot is a birth defect that is often hereditary. 
The ankle of the foot is turned to the side and is usually smaller or shorter than the normal foot, although it can also occur in both feet.
Left untreated it can lead to disability, pain and trouble walking, so it must be treated with methods such as stretching, casting, special shoes, braces or if these don’t work, surgery may be required.
Bowleggedness is an exaggerated bending outward of the legs from the knees down that can be inherited.
It is commonly seen in babies and most often corrects itself as the child grows.
If it has not improved after the child turns two, it may be a sign of a larger problem such as rickets or Blount’s disease.
Rickets is a bone growth problem usually caused by a lack of vitamin D or calcium, and is much less common today than in the past.
Blount’s disease causes an abnormal growth at the top of the tibia bone by the knee joint. It can appear suddenly and it’s cause is unknown, but to correct the problem the child may need bracing or surgery.
If bowleggedness occurs on only one side, or gets progressively worse, you should take your child to the doctor to rule out any serious problems.
Between the ages of three and six, many children show a moderate tendency toward knock-knees as the body goes through natural alignment shift.
Treatment is not usually required as legs tend to straighten on their own, but if one side is more pronounced than another, then see your doctor for advice.
Most toddlers are flat-footed when they first start to walk, or they tend to turn their feet inwards because of poor muscle tone or weak ligaments. 
Often this is simply a result of being cramped up in the uterus for so long.

In some children the arch in the foot never fully develops, and they appear to have weak ankles which turn inwards.
Flat feet is not usually considered an impairment, unless it becomes painful, and in this case, seeing your doctor is advised.
Special footwear, such as high-top shoes is not necessarily the solution, but arch supports may help if your child has pain. By the age of five, children should have normal arches in their feet.
Toe walking is common in toddlers, especially in their second year of life, and is not usually a cause for concern.
However, if your child walks exclusively on their toes and continues to do so after the age of two, they will need to see a doctor for treatment.
Sometimes this can be a sign of other conditions such as cerebral palsy or other nervous system problems, or the child may require casting around the foot and ankle to help stretch the calf muscles.
Sometimes toddlers walk with their feet turned outwards, and this tends to be more common in children who were born prematurely.
In most cases, it corrects itself as balance and posture improves as the child grows.
As for walking pigeon-toed, this is common when children are learning to stand and walk as their feet naturally want to turn inwards to help with balance and posture. It can also be hereditary.
In toddlers around the age of one, it is often caused by an inward turning of the shinbone, while in children aged older than three, it is due to an inward twisting of the thigh bone.
Treatment is almost never required as it resolves itself between the ages of three and five.
However, if it is severe or seems to involve the leg and hip, as well as the feet, or if it isn’t improving by the time they are two year old, see a doctor for advice as it may be a sign of other conditions involving the hip joint.
Fortunately, most feet and leg conditions correct themselves without treatment as the child grows and develops.
Others can persist or become worse as they may be linked to other conditions, so if you are at all concerned see your doctor, paediatrician or a podiatrist.
One important thing to know is that toddlers should go barefoot as often as possible to encourage balance, posture and co-ordination.
A baby learning to walk receives important sensory information from the soles of their feet and some shoes, particularly those with hard and inflexible soles, can make walking more difficult.
Children’s feet grow very quickly so their shoe size may need updating every few months.
Happy New Year to all my readers! 
Foot problems that need professional attention:
* Abnormally shaped toes
* Flat feet beyond the age of five
* Severe intoeing or out-toeing
* Bunions or other deformaties
* Ingrown toenails
* Stiffness in the foot
* Limping
* A sudden change in the way your child walks
* If your child isn’t walking at all by two years of age
* If your child complains of pain while walking or standing
You should see your doctor or podiatrist if you are worried about your child’s feet or gait.


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