Plain and simple, your child's feet should not be in pain. My name is Dr. Andrew Schneider, and I'm a podiatrist in Houston, Texas. In my practice. I work with children of all ages. Kids aren't little adults. They have foot problems that are unique to them. In today's video, I'll discuss how to keep your young child's feet healthy.
I see kids all the time in the office and around town and one thing that drives me crazy is parents who put shoes on their infants who are not yet walking. When I point it out, I usually get the same answer...But they're so cute! They are cute, but it's not best for your infant to be wearing a structured shoe.
The feet have lots of nerves that send feedback back to the brain. It's how your baby learns to stand and balance. It's best not to have a shoe between those nerves and the ground. Here's what I suggest. Until your baby is walking on his own, stick with cute socks or soft booties. Once your baby starts walking, then you can buy the cute shoes, but make sure they have a flexible sole. For early walkers, I generally recommend Stride Rite. #DontPutShoesOnInfants
Once your child is walking, you may notice some things that don't seem right. The first is #ToeWalking. This is when your toddler is walking on her toes and not putting her heel on the ground. At first, there's nothing to be concerned about. It's not unusual for it to continue until your toddler's second birthday. By three years old, though, your child should be walking with a heel-toe gait. Sometimes there are other causes of toe walking. It's unusual, but a short Achilles tendon can cause toe walking. Other neurological issues such as cerebral palsy or muscular dystrophy can also cause toe walking. If your child is developing normally, there's usually nothing to worry about.
Many pediatricians are unconcerned if toe walking continues until age five. As a podiatrist, I have some issues with that. Constant toe walking can cause the Achilles tendon to shorten and contract. This can lead to the feet having to compensate to get the heel on the ground. Where some doctors say, "See, I told you he grew out of it," the truth is that it puts your child at risk of other foot and ankle problems. These include flat feet, heel pain, and an unstable gait in general. Often the child will complain that his feet hurt when he runs long distances, walks, or plays sports.
If your child continues to walk on his toes, you should get him checked if he walks on his toes most of the time, if he has stiff muscles, if he's generally uncoordinated, if he walks awkwardly and stumbles all the time, if it seemed as though he can't bear his weight on a flat foot, if he has any other medical problems or has a family history of muscular dystrophy or autism, if he was born prematurely, or if he has previously walked flat-footed and only recently began to toe walk.
The next condition is when your child is #intoeing. This is commonly referred to as pigeon toed. One cause of this is metatarsus adductus. That's when the front of the foot is angled towards the midline of the body. You can tell if your child has metatarsus adductus because the outside of the foot has a convex "C" shape to it. If we catch this early, we can use casts to reposition the bones. Mild cases, often resolve, resolve on their own. But if it's left untreated, you may notice a bump on the inside of the great toe joint forming and that's called a bunion.
Another cause of in-toeing is tibial torsion. That's the inward twisting of the shin bone called the tibia. The tibia twists as it grows and as your child develops. If it doesn't twist enough, the toes will point in towards each other. This often resolves as your child grows and develops. We can help it along by using specialized insoles called gait plates.
These are insoles sometimes custom, sometimes not, the front edge flares out that flair helps to influence the tibia to twist, to resolve the tibial torsion, and that will help to stop the intoeing. When it comes to insoles, the result is not immediate. We're playing the long game as your son and daughter grows. In severe cases of intoeing, surgery may be done to resolve it. These cases are extremely rare.