Tiny Toes and Happy Steps: Nurturing Children’s Feet with Orthotic Care

Defining The Term Orthotic Inserts and The Need In Children and Youth

Orthotic Inserts for children and youth are specialized devices that are designed to provide support, promote balance, alignment, and proper structural and muscular development; thereby improving function in their feet, ankles, and legs. This is a critically important tool in preventing functional and structural pathology that might occur in adulthood. These orthotic inserts are often recommended by healthcare professionals, such as pediatricians, orthopedic specialists, or podiatrists, to address various conditions or concerns, including:

1. Correcting Foot and Leg Alignment Issues: Orthotics can help address foot and leg alignment issues in children, such as flat feet, high arches, or inward or outward turning of the feet. For children with significant differences in leg length, orthotics can help address the imbalance and promote more even weight distribution while walking or running. By providing corrective support, orthotic inserts promote proper alignment and development of the feet and legs.
2. Managing Overpronation or Supination: Overpronation (excessive inward rolling of the feet) or Supination (excessive outward rolling of the feet) can cause imbalances and contribute to various foot problems. Orthotics can help control and manage these issues by providing stability, balance, improving gait biomechanics, and reducing stress and pressure on the feet and lower limbs. In so doing orthotic inserts help prevent future problems as an adult thereby creating a lifetime of functional and psychological advantage
3. Alleviating Pain and Discomfort: Children may experience foot pain due to various factors, such as growth spurts, sports activities, or certain foot conditions. Orthotics can provide cushioning, shock absorption, and support, reducing pain and discomfort and allowing children to engage in activities with greater ease.
4. Enhancing Sports Performance: Active children involved in sports can benefit from orthotics, as they can improve biomechanical efficiency and enhance performance by optimizing foot alignment, shock absorption, and stability. Orthotics can be used to aid in the healing, prevention and reduction of risks related to sports-related injuries, such as stress fractures, shin splints, or Achilles tendonitis, by providing additional support and cushioning.
5. Preventing Foot Deformities: Orthotics can help prevent the development or progression of foot deformities in children, such as bunions, hammertoes or Achilles tendon issues. By providing proper support and alignment, they promote healthy foot development and reduce excessive strain on growing feet.
6. Supporting Special Conditions: Children with certain medical conditions like cerebral palsy or spina bifida may have unique foot and gait challenges. In addition, those with foot deformities such as clubfoot or metatarsus adductus may benefit from orthotic inserts which assist in proper positioning and alignment of the feet as well as balance. This in turn shields the individual from damage up and down the kinetic chain. One should note that orthotic devices can be fit to accommodate a wide range of specific needs; and can provide customized support as well as assisting in mobility and functional improvement.
7. Accommodating Orthopedic Devices: In some cases, children may require braces, casts, or other orthopedic devices. Orthotic inserts can be used to support these devices, ensuring optimal biomechanical control, comfort, functionality, and can optimize the intended function of the original orthopedic device.

Parents Concerns About Their Children’s Feet

Footwear, which includes the obligatory marriage between shoes and orthotic inserts, are often on a parent’s mind. As a matter of fact, as a seasoned podiatrist, two of the most common questions I have been asked throughout my career regarding children’s feet, is:

1. Should my growing children wear orthotic inserts?

   Children may benefit from wearing orthotic inserts in their shoes, especially if they have specific foot problems, such as pes planus (flat feet), pes cavus (high arches) or issues with foot alignment, balance, stability, congenital problems, such as tarsal coalitions (cartilaginous or bony attachment between the foot bones in the middle and back of the feet, which may impair movement and cause pain), or juvenile apophysitis (painful problem at the back of the heel particular during puberty). In the child with non-pathological feet, orthotics can help promote, proper foot development, alleviate discomfort and improve overall foot function and sports performance.

2. What age should a child start wearing orthotic inserts?

   The age at which children may start wearing orthotic inserts varies. It does depend on the specific foot condition and the child’s stage of growth and development. To alleviate symptomatic problems, there are children that require these devices at a younger age, while others may need to start using them during the adolescent years. It should be noted here that pronated or “flat feet” could be normal until they’re about six years old, by which time their arches have developed. In a general preventive and biomechanical sense, starting to use orthotic inserts around the age of six or seven, is often the recommendation of podiatric experts. If there are pathological issues that are starting to surface, then more aggressive therapeutic intervention may be needed before the age of eight.

The Development of Children’s Feet

It would be informative and useful to expound on the major points of the development of children’s feet to render a more complete understanding of biomechanics as a child grows into maturation. As children continue to grow, their feet become more structured, and the arches become more defined. By the time they reach their late teenage years, their feet are typically fully developed, although growth and changes may continue into early adulthood. The development of children’s feet is a gradual process that, in general, follows a general timeline.

Here Are Some Key Stages and Aspects Of Foot Development:

1. Infancy: From Birth to About 1 Year Old

   At birth, a baby’s foot is flexible and mainly consists of cartilage and is very flexible. Babies usually begin to crawl between 6 and 10 months, which helps strengthen their leg and foot muscles. From about 9 to 18 months of age, infants normally take their first steps and then transition into walking independently. During this period, their feet are actively growing and as the child grows and starts bearing weight, the arch begins to form.

   The foot will gradually develop bones and joints during the first years of life. Initially, the foot may appear flat due to fat pads, but as the child starts bearing weight, the arch begins to form.

2. Toddler Years: From About Ages 1-3

   During this stage, the first few years of life, infants’ feet are still mostly cartilaginous and flexible. As they start walking and becoming more active, their feet undergo significant changes. The foot muscles strengthen, and the arches are developing. The foot gradually becomes more stable and adapts to weight-bearing activities. It’s common for toddlers to have a wider and chubby foot shape, which tends to narrow as they grow. By the age of 3, most children will have developed a noticeable arch in their feet. However, it’s important to note that some children may have flat feet or low arches, which is typically a normal finding and usually would not be diagnostic of any pathology.

3. Childhood: From About Ages 4-11

   As children continue to grow, their feet become more proportional to their body size. The arches become more defined, and the foot structure matures. It’s important for children to have enough space and proper footwear to support healthy foot development during this high growth stage.

4. Adolescence: From About Ages 12-18

   During puberty, the foot development reaches its final stages. The bones in the feet ossify and fully form. However, growth plates are still present and vulnerable to injury until they close in late adolescence. It’s crucial for teenagers to wear properly fitted shoes to support their developing feet and avoid potential problems.

Throughout the entire development process, children’s feet are highly adaptable and prone to change. They can be influenced by factors such as genetics, activity levels, footwear choices, and certain medical conditions. Because of this dynamic and highly vulnerable process involved in the maturation of the foot, it’s essential for parents to provide a nurturing environment that includes proper footwear, which mandates wearing proper shoes and the correct orthotic inserts, regular foot care, and monitoring for any signs of foot abnormalities or discomfort.

The Bottom Line: Happy and Healthy Feet, Happy and Heathy Life

For me, what is vitally important in supporting our children is our responsibility to maximize their potential and to minimize any trauma; all for the purpose of having them live their best life. And so, using orthotics in children’s shoes, thus enabling them to able to fully participate in sports and other activities while being pain-free can offer several often-overlooked psychological and social advantages to a growing child, must be included in this dialogue.

These include:

1. Improved self-esteem: When children can actively participate in sports and physical activities without discomfort, they are likely to feel more confident and positive about themselves, leading to improved self-esteem.
2. Sense of accomplishment: Achieving success in sports and physical activities with the help of orthotics can give children a sense of accomplishment, boosting their motivation and drive to excel in other areas of life.
3. Social inclusion: Participation in sports can enhance social interactions and opportunities for children, allowing them to make new friends, build teamwork skills, and feel more connected to their peers.
4. Reduced stress and anxiety: Being pain-free while engaging in physical activities can reduce stress and anxiety levels in children, promoting better overall mental well-being.
5. Enhanced mood and emotional health: Regular participation in sports and physical activities is linked to improved mood and emotional health, leading to happier and more balanced children.
6. Increased physical activity: With orthotics providing comfort and support, children are more likely to engage in regular physical activity, which can have long-term health benefits and contribute to a healthier lifestyle.
7. Better academic performance: Physical activity has been associated with improved cognitive function and academic performance in children, making it easier for them to focus and excel in their studies.
8. Development of life skills: Sports involvement helps children develop essential life skills like discipline, time management, and perseverance, which can positively impact their personal growth and future success.

Orthotics: A Key to Healthy Growth and Active Childhood

Overall, the combination of using orthotics, participating in sports, and being pain-free can lead to a happier and more socially connected childhood, with potential long-term benefits for both physical and mental well-being.

In summary, these recommendations are essential during their development years to support and promote healthy growth of the feet, and, indeed, the entire body. Think of these as tools to support regular physical activity, including running, jumping, and participating in various athletic activities, which are all vital promoting the integrity of the whole foot, strengthening foot muscles, encouraging the proper development of bones, joints, healthy biomechanics, and overall foot health, and yes…your child’s overall well-being.