| From the moment our children are born, we | | | | to hinder the toe walking or plantar flexion/equinus |
| expect them to be perfect and beautiful. We | | | | and ensure correct foot position. For a more |
| count their toes, fingers and love all over them. | | | | supportive option, a brace called an AFO (ankle |
| As most of us realize, though, perfection is not | | | | foot orthosis) can be custom made and utilized as |
| always the case. Some children, have problems | | | | long as needed to prevent the reoccurrence of |
| with their feet from birth, while others may | | | | toe walking. If no neurological conditions are |
| develop problems in the early years. | | | | present this time period is approximately 3 to 6 |
| Toe Walking "Ballerina feet" or toe walking is one | | | | months. Flat Feet Another foot problem is flat |
| such problem. Causes of toe walking include | | | | feet (pes planus) or "Fred Flintstone feet". This is |
| tightness in the heel cords at birth, habitual toe | | | | something that can be and is often normal for |
| walking or neurological conditions such as Cerebral | | | | young children. Arches develop over time. The |
| Palsy or Duchenne's Muscular Dystrophy. Although | | | | foot muscles actually exercise and get stronger |
| many children learning to walk tend to go up on | | | | best when walking barefoot. Flat feet can be |
| their toes, should this continue past the age of 18 | | | | considered a problem when the child complains of |
| months, a physician consultation is necessary to | | | | pain in the feet or lower legs after walking. |
| determine causes and treatment options. You | | | | Children may not always give you a clear picture |
| may think the child looks cute walking on his/her | | | | of what they are feeling. So as a parent, one |
| toes, but that ballerina look will be the focus of | | | | must be observant as to the way a child's shoes |
| teasing when that child becomes school age. | | | | wear down over time; paying special attention to |
| Treatment options can be as simple as stretching | | | | the heel position. |
| the tight calf muscles. Other options include serial | | | | If the wearing of the shoe is more on the inside |
| casting, orthotics, or surgery. If a child just has | | | | edge and it looks like the heel is positioned more |
| the habit of walking on their toes but can change | | | | to the outside, then you may have a child that |
| this behavior on command, it may still be | | | | has flat feet. Another basic test is to see what a |
| necessary to intervene with serial casting or | | | | wet footprint looks like. If you think Fred |
| orthotics. The child may change this habit when | | | | Flintstone, than you may have a child that has flat |
| told repetitively, "Don't walk on your toes...don't | | | | feet! The most important thing is to pay attention |
| walk on your toes," but before long both the | | | | to their complaints of pain after walking. Flat feet |
| parent and the child will tire of this necessary | | | | without pain do not necessarily indicate a need for |
| nagging. | | | | treatment. Just like toe walking, there can be |
| Although serial casting or bracing may seem | | | | many reasons for flat feet other than an arch |
| extreme, don't let the title scare you; it is just a | | | | not developing normally, such as Down's |
| short term treatment to provide a slow sustained | | | | syndrome, hypo tonicity (low tone) or |
| stretch to the tight muscles. Serial casting is | | | | developmental delay. If your child has any of |
| applying a cast on the lower leg to allow a | | | | these diagnoses, you may also need to discuss it |
| prolonged stretch on the tight calf and Achilles | | | | with your physician and decide if orthotics are |
| tendon. The cast is removed weekly and reapplied | | | | necessary as an adjunct treatment. Orthotics for |
| in a more optimal stretched position until it is | | | | flat feet are used to support the arches and |
| adequate for the child to walk with heel strike at | | | | provide a better mechanical advantage for the |
| initial contact during the walking phase. After the | | | | foot to be able to walk correctly. The feet are |
| casts are removed, it may be necessary to put | | | | the structural foundation of the body, therefore, |
| some type of orthotics in the shoes to reinforce | | | | supporting the feet in their optimal alignment |
| the heel strike and continue the child's progress. | | | | allows for the muscles in the legs to activate at |
| Other orthotic choices can be discussed with a | | | | their best. If you have questions about orthotics, |
| certified orthotist. Some could include orthotic | | | | please consult your physician and then seek out a |
| inserts which go inside the shoes. These can help | | | | Certified Orthotist who specializes in children. |
| to support the arch and also provide some rigidity | | | | |