Childhood foot problems can have both immediate and long-term effects. During growth, the normal development of the pelvis and the spine will suffer if there is a foot imbalance. A budding athlete’s skill level – even running at recess – can be significantly affected. Later on, foot problems from childhood can interfere with adolescent (or adult) spinal function, which can result in poor biomechanics and accelerated degenerative changes in the knees, hips and spine. With a relative quick screening of their younger patients. Chiropractors can identify those who need early intervention, and then provide proper custom-made orthotic support.
Early Development
During early development, and especially as we begin to walk, the lower extremity changes significantly. The legs undergo rotation, in order to allow the feet to align with the knees and hips for smooth gait. The arches slowly become more obvious and increase in height as our gait improves. Most problems arise when the feet and legs do not align properly (in-toeing or out toeing), or when the main longitudinal arch does not develop fully.
Screening Exam for Orthotics
A very quick method for checking kids for the need for orthotics follows:
- Observe the child’s gait.
- Knee to foot alignment.
With young patients, the most common fault is in-toeing followed closely by excessive toeing out (foot flare). This can be identified by looking at the alignment of the foot with the lower leg as your patient walks. An angle that is either less than 5 degrees or greater that 15 degree is a red flag for excessive rotational torque stresses into the knees, sacroiliac joints, and spine.
Look at the lower legs of the child from the front. Mentally drop a straight line down from the mid-point of each kneecap to the foot. This imaginary plumb line should strike the foot over the first two metatarsals. If the knees point out or in when the feet are straight ahead, or if there is a valgus angulation(knock-knees), another red flag is raised.
