Parents are
constantly asking me whether their child’s flat foot should be treated or if
they will “grow out of it”.
This is one of the
most controversial current topics in pediatric foot care and the debate is
really over how to decide when treatment is warranted for pediatric flatfoot.
The controversy rages most loudly when the flat foot in question is without pain.
Many pediatricians tell parents that their child will indeed “grow out of it.” If
this was true, why are we treating so many symptomatic flat feet in adults in
our Grapevine, Texas office?
It
is easier to get agreement that a child with a symptomatic flatfoot should
receive treatment. No one thinks a child in pain should be left untreated,
especially given the myriad of options we have to relieve that pain. In that
subgroup, the controversy is often over what type of treatment — off-the-shelf
devices or custom orthotics — the child should receive.
The
greater challenge for today’s podiatrist is having the ability to discern
when treatment is necessary for children with painless flatfoot. Bear in mind
that a painless flat foot does not imply an asymptomatic flat foot. Children
often express their symptoms without reporting any pain. They may be lazy,
frequently ask to be carried, prefer sedentary activities or have trouble
keeping up with their peers. This can lead to childhood obesity issues and life
long disability.
Only doctors
who discuss these issues with the parents will uncover subtle manifestations of
the flat, poorly supportive foot that are already contributing to changes in
activity level and functional ability. The first step in identifying flat feet
that require treatment is to uncover the subtle changes in activity level and
performance that may well be caused or aggravated by foot misalignment and
dysfunction. After one has started treatment, parents often report a
significant change in children’s activity levels, which is often to the great
satisfaction of the parent. The children themselves are happier, healthier and
more active as well.
Powersteps had come out with
a great pre-fabricated device that can get a symptomatic flat foot under
control quickly. They are inexpensive and a great first line therapy for these
children. They are also readily available at Healthy Steps! Some kids still
need a custom functional orthotic, but at least we can get them on the road to
recovery much quicker with these devices.
If your child has low arches
or flat feet, bring them in for a biomechanical exam and ou doctors can talk to
you more about the long reaching problems that can be avoided by treating their
flat feet.
