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This is important. Your child's feet should never hurt. Ever. There are times where our kid's foot needs some additional support in order to make them more stable and walk and run without pain. 

In a perfect world, your children would go through life with no pain in their feet or ankles. They'd be able to run and play sports without worrying about pain. They should be able to buy whatever shoes fit and feel great to them. Unfortunately, that's not always the case. A lot of causes of foot pain in kids is because of instability as they grow and develop. When your child starts walking, you may notice that he has a flat foot. All babies start life with a flat foot. That's because the structure and stability of the feet is provided by the soft tissue as the bones develop. Young children also have a very thick fat pad on the bottom of their foot, and that contributes to their foot appearing flat. Now, as your child develops, the bones start to provide more support and the arch develops. The flat foot can persist until age five. That said, the ankles shouldn't be rolling in. 

If you see the inside of the ankles reaching for the ground, it's time to come into the office to get evaluated. Proper footwear for children starts when they begin to walk on their own. Before that, you should only put socks or soft booties on your child. Up until age two to three, don't be concerned about support inside of a shoe. Choose a shoe that has a flexible sole for early walkers. I generally recommend Stride Rite. This allows the foot to develop naturally and properly. I don't consider putting a child in any sort of additional supportive device, such as an insole or an orthotic, until age three. When I see a child who has a very flat foot, whose ankles are rolling in and approaching the ground, and has a family history of flat feet, I'll consider intervention. 

My first step is to make sure she's wearing the right shoes. If I don't think a shoe is stable enough, I'll recommend an insole. My first inclination is to use a medical grade insole made, especially for children. You may find insoles in the pharmacy that are geared for children. They're usually foam insoles and don't provide enough support. They're just too floppy. 

I recommend and use in my office specialized medical grade insoles called Little Steps. They're made of a firm plastic that cradles the foot and repositions it to a position of stability. They have a deep heel cup to control the position of the heel. They also have flanges on both sides to support the foot. There is no other insole that is as well constructed and as effective as Little Steps. 

Sometimes, even a pediatric medical grade insole isn't sufficient to control the foot. In those cases, I recommend a custom orthotic. A custom orthotic is a specialized custom shoe insole that is made from a mold of the child's foot. Because it's made from a mold of the foot, I can maximize the support and control that it has. First I evaluate your child's foot mechanics with a comprehensive series of measurements called a biomechanical examination. I then watch your child walk to see how the feet function when they're being used. I take some more measurements with the child standing, and ultimately take a mold of the foot. The mold is taken in what is the most stable position of the foot.

I then send the molds to a lab and have the custom orthotics constructed. Because of everything that goes into creating the custom orthotic, they're not just supportive, they're corrective. The goal of the custom orthotic is for the device to manage all of the compensation that the foot has been doing itself. This allows your child's foot to work as efficiently as possible. If you've noticed your child's feet are flatter than you think they should be, or they're complaining about pain when walking long distances or while running, let's get them in for an evaluation to see how getting the right support will help.