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Get Ahead Kids - Vol. 3, No. 2 - March/April 2011

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Feet Fit for Physical Activity

By Adam Glascock

There is a saying "as the twig is bent, so the tree will grow". This means if a deformity is left untreated it will develop further through continuing deforming forces of walking and activity.

There is a wonderful window of opportunity given to parents and health practitioners to embrace so that children are given the opportunity to develop normally.

If there is any inherited foot, leg, or gait (walking) problems that are known to the family, these issues should trigger the need to have your child assessed. Often times this shows up with a child who struggles in participation in sport.
There are some myths surrounding the development of children's legs and feet.

It is often heard that children will "grow out of it", as concerned parents have their child assessed by health professionals.

We in podiatry, unfortunately, so often witness the reverse to this myth. Rotational deformities of the limbs for example, are potentially reversible if it these are managed at an early age. We see children develop "night pains" in the legs, excessive fatigue when walking, i.e. wanting to be picked up, and poor foot posture as a consequence of a malalignment of the legs that could have been diagnosed in the first few months of life and managed appropriately.

These alignment issues can develop in utero from different causes:

  • A large baby in weight
  • A long baby in length
  • A small mum
  • A breach position
  • Multiple births

Some babies simply get "caught up" in that last three months of pregnancy. This puts undue pressure on their legs & feet.

Let's talk ballet

Ballet exercises are wonderful for the muscular, nerve and structural development of your child's skeletal system. Flexibility, poise, self confidence are all major benefits of these exercises.

However, the foot is not structurally sound enough to support en pointe (on the tips of their toes), till about 14 years of age. This can be assessed by your Podiatrist via X-rays of the feet starting at 12 years of age, to determine bone maturity.

It is recommended that girls do not go en pointe in ballet until bone maturity has developed and that the parents are fully aware of the consequences that this position can cause to the foot. Discussion should take place between the child, parents, ballet teacher and Podiatrist.

Let's talk about other sports

Sporting activities in the older child can create various scenarios that may lead to injuries in the feet and legs. Advice from your podiatrist is recommended with such sports, which are more aggressive, as netball, football (all codes) and long distance running to avoid such conditions as:

  • Ankle instability
  • Heel pain
  • Shin pain
  • Hip pain
  • Foot pain
  • Knee & knee cap pain

Biography

Adam Glascock is the principal podiatrist at Newcastle Family and Sports Podiatry in Hamilton East, Newcastle. His main field of practice is paediatric and biomechanical abnormalities in children.

He heads a team of thirteen staff and his special interests include improving the gait parameters and performance of elite junior athletes.

When it has the opportunity to assess a new born or youngster, particularly before they are walking it is possible to diagnose a misalignment, medical or structural issue that will manifest and develop with the child particularly through weight bearing. This will often become noticed for the first time as the child becomes involved in physical activity and sport.

More Information

Adam Glascock
B APP SC (POD)
Newcastle Family & Sports Podiatry
51 Denison St.
Hamilton East NSW 2303
P: 02 4961 4411
admin@newcastlepodiatry.com.au
www.newcastlepodiatry.com.au


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Checklist

  • Has your child been assessed by a Podiatrist who treats children, especially babies? The earlier the better! It is always a relief for you as a parent to hear that your child is 100% healthy rather than have missed an alignment problem &
    have it develop into a more substantial condition that will stay with your child for life. Ideally, have the assessment before the child walks - 6 to 9 months is great!
  • Don't force your child to walk early. They will stand then walk when they are structurally able to do so. However, if they are not walking by 18 months, please consider professional advice.
    "Bare feet" are great for little feet. Soft sole shoes (first walkers) should be used around 12 to 18 months to encourage neural (nerve) feedback from the ground as well as adding protection to their feet.
  • Baby feet are "flat feet" & this is normal. They have a lot of development of the small muscles in the feet before a small arch is formed around 2 years of age. However, there is a difference between a flat profile foot & feet that are out of alignment. Your Podiatrist who treats children, is the best person qualified to recognise this difference.
  • Thongs are not good for the development of their feet. Certainly they can be used to wear to the beach for protection, but should not be worn for long periods.
  • Sandals are much preferred, but the more straps to hold them onto the foot the better.
  • School shoes, ideally should be laced & made of leather, with a firm heel counter & strong midsole.
  • Sport shoes that are of a recognised brand & quality are also an ideal shoe, but ideally should be kept for sport & activity. Your Podiatrist will also be able to recommend the correct sport shoe for the child's foot type & activity.
  • Following the assessment of the child it may be recommended that different sports & activities, for example ballet, skating & cycling would assist in the correct development of your child's lower limbs.

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