Do I Need To Treat My Child’s Feet?

My 2 year old boy had recently acquired some brand new runners courtesy of Nanna.

They’re really flash, hyper coloured ones.

Naturally they’ve drawn some attention from other parents and knowing my line of work the onset of Podiatry related questions has been almost inevitable.

Some parents I spoke to had discovered that, as with many things, their Child’s feet or leg alignment was indeed not perfect.

The recurring theme is confusion surrounding whether to leave it alone, wait and see, or to intervene with treatment and to what extent to intervene?

So I’ve found myself regularly reciting an explanation I’ve delivered to parents many times prior to making my recommendations on treatment, or my recommendation to leave the child alone for now.

Let me start by saying to all the parents out there… You’re not the only ones that this question causes stress and anxiety for.

Nearly every parent I’ve consulted has wondered the same thing,

Should I be treating this problem or leaving it alone?

The fact is, even health professionals are wondering this. To intervene (treat) or not to intervene is a hotly contested and continued debate within health professions, and Podiatry is no exception.

Some research has shown a worsening long-term effect of treatment. Other research has suggested no change at all as the result of immediate treatment.

But is creating a long-term change always the goal?

Here are my 5 criteria for making a recommendation to treat or not to treat.

 

1. Is the child in pain?

If pain is present, in my opinion it’s a no brainer, we should recommend intervention. Pain however, is sometimes very difficult to determine in a baby or a toddler.

Look for signs you may be missing.

Does your child always want to be picked up or put in the pram, after very short periods of time?

Is your child consistently wanting to sit down and do sedentary activities, while all the indicators suggest they would want to be playing (such as when they are with a group of similar age children who are off playing).

If your child is a little older, consider the fact they may have a consistent level of discomfort, not pain exactly, but some physical limitations such as tightness, aching etc where they might not know any different as they’ve had it since they started walking/running.

This might manifest itself in gravitation toward sedentary activities.

I often find myself explaining to parents that a heavy and continued interest in music, books or art is wonderful, so long as those interests are born out of a genuine interest, not due to any physical limitations. Limitations which may have reduced the enjoyment of physical activities.

Step back, observe your child and think.

Does my child really enjoy that activity, or are they avoiding something else?

If it’s the latter, they may be harbouring some sort of pain or discomfort.

 

2. Is there a strong family history?

Is there a genetically close family member, a sibling, parent, grandparent, aunt or uncle that has the same issue?

Does that family member experience any problems such as pain, discomfort, physical limitation etc?

If the answer is yes, It’s a strong indicator to get started with treatment, regardless of whether the problems have become evident in the child.

 

3. The ‘severity’ or level of the issue

 If the issue in question happens to be a structural concern, such as flat feet, dropped arches, or in-toeing (pigeon toed) the level of the misalignment is taken into account.

If it’s significant or severe, or if avoiding treatment now is going to make it harder to treat in future if needed, this would be a reasonably strong indicator for treatment.

 

4. Are they keeping up with their peers

In criteria 1 we addressed subtle pain or discomfort potentially impacting on children’s choice of activities. Here we are not investigating pain, but rather physical abilities.

If a child is falling behind their peers, when running and playing around, that’s fine (we can’t all be Usain Bolt) however if there is a physical limitation in your child’s assessment, that together we feel is decreasing physical abilities, that may be a indicator to treat rather than not, if we feel the treatment may improve performance.

 

5. Is the required treatment justified by the problems found in criteria 1-4 and the professional assessment?

We don’t need to use a shotgun to swat a fly do we?

If the problem is considered minor the ‘treatment’ may well be to sit it out, and see what happens over time. Does it get worse, or does it get better?

If the problem is more severe, are we wasting time and effort with treatments that are too conservative or minor? At the end of the day there needs to be a nice balance of potential problems Vs potential rewards. _____________________

 

NB: Be cautious of any health professional that does not address these above criteria, either directly or indirectly, through the questions they ask and the assessment they make. All practitioners will go about things in a different way. Now that you are familiar with my criteria, you’ll no doubt recognise a focus on these areas with your own Podiatrist.

They may fall on either side of being too conservative, too enthusiastic to treat, or dare I say it, looking too much at the potential transaction value of your appointment.

At the end of the day you the parent need to be comfortable that the practitioner has your child’s best interest at heart. If you doubt it, even for a moment, seek a second opinion.

Generally problems of the feet or legs don’t need to be rushed, and a good practitioner will often send you away for 6-12 months so they can monitor development and make a comparison from ‘time point A to time point B.’

They will also let you know if it is urgent.

Above all, try not to be too anxious about things. Most Podiatry treatments with children are gentle and very well tolerated by your child.

At Geelong Foot Clinic, and other reputable Podiatry clinics, it is perfectly ok for you to delay the onset of treatment or cease treatment in the event you have a change of heart. You are always in control.

If your Podiatrist is covering off on the above criteria, you can rest assured that your decision will be the best one based on the information you have.

Written by Stephen Iannazzo. Stephen is a Geelong Foot Clinic Podiatrist with 12 years experience treating Children in Private Practice. If you would like access to more of his information feel free to subscribe below.