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Should I take my child to a Podiatrist?Greg Mack, DPM During my twenty three years of practice, I have had the privilege of treating hundreds of children with a variety of foot deformities. One question I am asked over and over again, “Is it necessary for my child to see a podiatrist?” Often times a parent may have a concern that they may have addressed with their family doctor and perhaps were told, don’t worry about it your child will grow out of it. This is not always the case and a second opinion many times is warranted to provide parental piece of mind. There are several conditions a parent should consider that will help determine whether or not a child should be evaluated by a podiatric specialist. If your child appears to be bowlegged or possibly have flat feet, the rule of thumb is that most children will outgrow this deformity by age three or four. At this time the parent should sit back and watch as their child walks away from them. The child should be wearing shorts in order to be able to watch their legs and ankles. The parent should notice that their child has lost their “waddle” or toddler gait that is so fun to watch as they begin to learn to walk. The parent should notice that the child is beginning to develop and walk with a heel to toe gait. If the child’s ankles are rolling in it is definitely time for a podiatric evaluation. If the child is complaining of cramping and discomfort, then a custom molded orthotic is warranted. These specialty inserts can be fabricated that will fit into the child’s shoes that will control this deformity and virtually eliminate all of the flattening of the foot. The podiatrist creates the mold specific for your child. It is a painless procedure that will allow your child to walk correctly and prevent a deformity that could affect them the rest of their life. Parents also may question, “Have I waited too long?” Is it too late for my child to get inserts to help them walk correctly? If the parent is thinking this, again it is definitely time to have your child evaluated. If a child’s growth plates in the foot are still intact, there is an excellent chance that the joints can be repositioned just with inserts – avoiding a multitude of surgical reconstruction that may be required at a later date. If your child is getting older and complaining of a pain in the arch, usually between the ages of nine and thirteen, the parent should have a podiatrist evaluate this condition. X-rays would normally be taken and often the cause of this is called an accessory navicular bone. This is an extra bone that is present in the arch of the foot. Treatment of this most likely would be surgical. Removing this extra bone will allow the major tendon that holds up the arch to function properly. There is no need to completely detach the tendon in this procedure and little risk of rupturing the tendon this way. Fitting them with orthotics following this procedure will help them have a normal foot as they get older.
As a child grows and becomes more active in playing and participating in sports they may complain to the parent that they are having knee or hip pain. Often this is associated with the child having a collapsing foot. There may be a family history of foot problems as well. If the parent notices one foot flattening more that the other, this typically indicates that one leg is longer than the other and this is known as limb length inequality. Again this deformity is easily treated with orthotics by adding the additional height to the orthotic for the shorter leg. Our feet tend to take a beating with everyday activity. We have created an environment where we walk and stand on extremely hard surfaces. The foot is not designed to structurally accommodate these hard surfaces and it is important to provide the right mechanics and shoe gear to allow the child to function properly. Parents be proactive, be informed and don’t be afraid to question.
If by age three you feel your child is not walking or running properly, their ankles appear to be rolling in, there is family history of foot problems or your child is complaining of pain or cramping, have them evaluated by a podiatrist. This will allow not only peace of mind, but may also help prevent future surgical corrections for your child. This one simple step can help assure them a lifetime of being active and functional without pain in our very active world. Dr. Greg Mack – Foot & Ankle Clinic |
