Children’s podiatry

March . 17th . 2021 | Orthotics

As with other areas of our health, when it comes to children’s podiatry a unique set of needs and factors need to be considered. This is because children’s bodies are undergoing a constant journey of change, a process that continues into their late teens. You might be surprised to know that at birth the foot contains no bones whatsoever! Instead, there is cartilage which eventually ossifies into the 28 bones that make up the human foot. 

With all this change comes an increasing demand on the legs and feet and sometimes kids may need a little help to keep up.

Some indicators that your child might need some assistance:

  • Difficulty keeping up with peers
  • Quick to fatigue
  • Tripping and falling more often
  • Complaining of pain during and following activity
  • Intoeing
  • Knock knees
  • Toe walking
  • Flat feet
  • Heel pain (often Sever’s disease)
  • Delays in achieving developmental milestones

Not all kids will complain or even be able to express the difficulties they are having, and instead may start walking differently as a compensation for pain. This attempt to adapt may lead to problems occurring in other areas of the body (knees, hip and back), less efficient movement and could affect development. 

Other common issues that can cause pain and can affect movement in your child 

  • Plantar warts (verrucae)
  • Ingrown toenails

If you notice any of the above signs, an assessment with a podiatrist is worthwhile.

Our approach to children’s podiatry

If you have concerns, the best course of action is to simply make an appointment with us and get the right advice from our professional team. It may be that there is no intervention or treatment required. We are always pleased if all we have to offer is reassurance that your child’s development is well on track! 

At Erko Podiatry your child will receive a comprehensive assessment which takes into account their age / development stage, medical history, current sports or activities, analysis of their movement (posture and gait analysis) and range of motion – all with a particular appreciation towards the needs and demands of a developing body.

Any assessments will be explained to you and your child, along with an explanation of the diagnosis and treatment options. If we think anything requires further investigation we may refer for imaging or other specialist assistance.

Frequently asked questions about kids feet 

Does my child need orthotics?

Flat feet in children can be a normal finding, depending on developmental stage and your child’s foot function. Orthotics can however play an important role in the treatment of certain conditions. If you suspect that your child might need or benefit from the use of orthotics, a podiatry assessment should be your first move. 

We look at children in context of their age, expected ability, joint range of motion and strength. Combining this with a history of issues such as limping, toe walking, inability to keep up with peers, flat feet or just being more clumsy than expected. We will then have a much better idea about treatment options. This can include kid’s footwear advice, issuing different types of orthotics, home exercise program, referral for further scans or to other specialists. 

Orthotics come in all shapes and sizes. If incorporated into your child’s treatment plan, we will recommend and fit the most suitable type and size. 

What are gait plates?

These are a special kind of orthotic. They extend to the toes and help to reduce the ability for a child to turn their feet inward. If you think your needs gait plates, please book an appointment first and have this assessed.

What is Sever’s Disease?

Any parent will attest that sometimes it seems like their kids go to bed one night and wake up the next day taller! Kids bones are still growing, including the bones in their feet and legs. This growth comes from an area of the bone called the growth plate. Until these growth plates close (ossify), the area is susceptible to inflammation, leading to pain. Inflammation of the growth plate is called apophysitis. 

Sever’s disease is an apophysitis of the heel bone (calcaneus). 

Kids are particularly vulnerable to Sever’s disease due to the increased rate of growth in the leg bones leading to tightness of the calf and increased pull on the Achilles tendon and growth plate. If you suspect your child might be suffering from this, seek advice early as there are effective treatments available that can really help your child to get back to sport and play!

severs disease

I have been told to watch out for ‘W’ sitting. What is this?

‘W’ sitting, whereby the child sits on their knees with their legs splayed to the outside in a “W” configuration, is best avoided. This position, while not harmful in short bursts, if performed repeatedly or at length, can place a twisting force on the bones of the legs. Growing bones are very pliable, in that bone growth is readily affected by the direction of forces placed on them. A “W” sitting position can therefore lead to their bones forming in an inwardly rotated way, contributing to issues such as toe walking. 

Prevention requires your watchful eye and being persistent with your child, with swift correction or frequent reminders to place their legs in front or crossed.

kids w sitting

What activities should I encourage my child to participate in?

Any safe, active interests should be encouraged. Moving, playing and engaging in physical activity provides the healthy stimulus the body needs to grow and become stronger. In particularly active children, overuse injuries may emerge and these are a large part of what we see in kids.

Tailoring the variety and types of activity may be needed to assist with overuse and overloading injuries. For instance, substituting some running type activities (basketball, soccer, football) with some swimming or cycling can be a great way to help the body.  Lower impact type activities can be a great way to keep muscles and joints moving without the high and repetitive impact to deal with. 

This is where other treatment options may also be suitable. These can include supportive footwear, muscle strengthening and stretching and orthotics. 


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02 9037 7395
1/154 Henderson Rd, Alexandria NSW 2015 Jobs and Erko Podiatry

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