What Makes Hip Dysplasia Worse In Babies?

Hip dysplasia in babies can be a concerning condition for parents. Hip dysplasia occurs when the hip joint doesn’t develop correctly, leading to hip instability and potential dislocation. In infants, this condition can either be present at birth or develop during the first few months of life. Signs of hip dysplasia may include clicking or popping sounds in the hip joint, limited range of motion in the legs, and asymmetrical thigh folds. In many cases, it’s not the parent that first notices anything unusual related to the hips, but a health provider (like a doctor or midwife) that points out the need for further investigation in the form of an x-ray.

Causes of Hip Dysplasia

While the exact cause of hip dysplasia is not always clear, certain factors can increase the risk. These include breech positioning in the womb, a family history of hip dysplasia, and being a firstborn child. Additionally, tight swaddling or prolonged positioning of the legs in a straight position can contribute to hip dysplasia.

What Should You Avoid With Hip Dysplasia?

To prevent exacerbating hip dysplasia in your baby, it’s crucial to avoid certain practices. Firstly, refrain from swaddling your baby tightly with the legs straight. Instead, opt for swaddling techniques that allow for natural hip movement. Avoid using baby carriers or devices that force the legs into a straight position for extended periods. Ensure that your baby spends ample time in positions that promote healthy hip development, such as lying on their back with their knees bent and hips spread apart.

How Can I Improve My Baby’s Hip Dysplasia?

If your baby has been diagnosed with hip dysplasia, there are steps you can take to help improve the condition. Your doctor may recommend using a special harness or brace to keep the hips in the correct position. These devices help to gently guide the hip joint into place as your baby grows. Additionally, engaging in activities that promote hip flexibility and strength, such as supervised tummy time and gentle stretching exercises, can aid in improving hip dysplasia.

When Is It Too Late to Fix Hip Dysplasia?

Early detection and intervention are critical for effectively managing hip dysplasia in babies. In most cases, treatment initiated during infancy can lead to successful outcomes. However, the window for non-surgical interventions narrows as a child grows older. Generally, if hip dysplasia is not addressed promptly during infancy, it can lead to long-term complications and may require more invasive treatment options later in life.

During infancy, the hip joint is still developing and can be more easily guided into the correct position with non-invasive methods such as harnesses or braces. These interventions work by gently coaxing the hip joint into place as the baby grows, taking advantage of the body’s natural growth and development processes.

As a child gets older, the hip joint becomes more established, and the bones start to harden. This makes it increasingly challenging to correct hip dysplasia without surgical intervention. While surgery may still be an option for older children and adolescents with hip dysplasia, it often involves more complex procedures and longer recovery times.

Can Infant Hip Dysplasia Cause Problems Later In Life?

While early detection and treatment of hip dysplasia in infants can often lead to a full recovery, untreated hip dysplasia can result in significant problems later in life. Adults who had untreated hip dysplasia as infants may experience chronic hip pain, arthritis, and mobility issues. Therefore, it’s essential to address hip dysplasia early to prevent long-term complications, maximise the chances of a successful outcome and minimise the need for surgical intervention in the future.

What Is It Like To Have A Baby In A Hip Harness Or Brace

Having a baby in a hip harness or brace can be initially overwhelming for parents, but remember that these devices are designed to promote healthy hip development and prevent complications associated with hip dysplasia. The harness or brace may feel restrictive at first, and your baby may need some time to adjust to wearing it. However, most babies adapt quickly and continue with their daily activities without much difficulty. Parents may need to make some adjustments to clothing and diapering to accommodate the harness or brace, but with time, it becomes a routine part of caring for their baby. While it may be challenging emotionally to see your baby in a harness or brace, knowing that it’s helping to correct a potentially serious medical condition can provide reassurance and peace of mind. 

FAQs

Can hip dysplasia be prevented?

While hip dysplasia cannot always be prevented, certain measures such as avoiding tight swaddling and ensuring proper positioning during infancy can help reduce the risk.

Is hip dysplasia painful for babies?

In most cases, hip dysplasia does not cause pain in infants. However, as the condition progresses, it can lead to discomfort and difficulty with mobility.

Will my baby need surgery for hip dysplasia?

Surgery is not always necessary for treating hip dysplasia in infants. Many cases can be managed with non-surgical interventions such as bracing or harnessing.

How often should my baby be screened for hip dysplasia?

Screening for hip dysplasia is typically performed during routine well-baby exams. Your paediatrician, midwife or doctor will assess your baby’s hip development and may recommend further evaluation if any concerns arise.

Can hip dysplasia affect my baby’s ability to walk?

In severe cases of hip dysplasia, mobility may be affected. However, with early detection and appropriate treatment, most babies can achieve normal walking milestones.

Buying School Shoes Online? How To Measure Kids Feet Accurately

There’s not much time left before the new school year begins, so for our podiatrists, it’s the time where we find ourselves offering a lot of advice to parents around buying kids school shoes. Now traditionally, advice on buying school shoes focuses on making the purchase at a physical store and includes things like:

  • Ensure you try both shoes on together and check the fit of both, as one foot is often slightly longer than the other
  • Try shoes on in the afternoon rather than in the morning due to the natural swelling that can occur during the day
  • And so on…

But the reality of a post-COVID era is that for time and convenience reasons (as well as health and safety), many more families are choosing to make their school shoe purchases online. So to help, we thought we’d share some tips on how to measure your children’s feet accurately and how to help get the best fit for your online shoe purchases.

1. Print The Brand’s Sizing Chart, If Available

Most brands will have a printable sizing chart available – just like this one from Bobux. If you can locate it online (it may be on the brand’s page as opposed to a particular store’s page) then print it out and make sure that ‘Page Scaling’ on your printer is set to ‘None’ and not ‘Fit to Printable Area’. Once printed, use a ruler to make sure it’s correct. Then place the chart on a flat, hard floor and place your child’s heel level with the baseline.

Make sure your child is standing with both feet taking even weight and always measure both feet. You want to record the size of the biggest foot and the tip of the largest toe – this isn’t always the big toe, it may be the second toe. For school-aged kids, you want to allow approximately 2cm for growth.

The reason we love a sizing chart is that we’ve found that some brands have a notable sizing difference and given how quickly children’s feet can grow, you really want to get the right size. And save yourself the hassle of a return or exhange.

2. Ruler Or Tape Measure

If no printable sizing chart is available and the site only offers measurements in centimetres, place one side of your ruler or measuring tape against a wall that is connected to a hard, flat surface (not carpet). Place your child’s heel against the wall so that it is gently touching. You can then level another flat object – like a piece of paper, a book, another ruler or something similar against the end of the longest toe, whichever that is, and read where it intersects with the ruler. 

If the above doesn’t work, you can always make a mark on the floor (even with something easily erasable like a highlighter) and then take the measurement from that point. Again, allow a further 2cm for future growth, and select the appropriate size.

3. Assess The Shoe Type

Next, when coming to make that online purchase, look out for school shoes that are:

  • Leather – we prefer leather for its many benefits, which include stretching to grow with your child’s feet for that little bit longer
  • Have laces or velcro – having good fastening mechanisms means you get the longest lifespan out of your shoes by adjusting the fastening mechanism as they grow. It also means that the shoe is secured to the foot properly so the foot doesn’t have to forcefully grip at the base of the shoe for support and control, but can just relax. Buckles come after laces and velcro but are still superior to slip-ons.
  • Aren’t too heavy – children take thousands of steps in their school shoes every day, day after day. This means that the weight can definitely add up and either help them stay healthy, happy and pain-free on their feet – or it can lead to those frustrating aches and pains at the end of the day. Opt for lightweight shoes, especially when muscles and muscle strength are still developing.
  • Choose watertight materials where possible – good materials to help keep feet dry include synthetic leather, neoprene, rubber, and gore-tex, to name a few. For natural leather, you can use products like waterproofing oils, sprays and creams and wax products, as directed on the label.

4. Read The Reviews

Traditionally, when offering shoe fitting and purchasing advice, we’d promote checking the level of the support that the shoe can offer – in the arch, the heel counter and more. As you’re not able to do this online, we recommend reading the reviews, which can be found across a range of websites that stock the particular shoe style you’re looking at purchasing. Check what other parents have said and whether they recommend this shoe style. One of the things we do is to filter the reviews and remove the 4-star and 5-star reviews, so you’re just left with the lower-star rankings. If multiple people have complained about the shoes’ tendency to break apart or lead to aches and pains, take this into consideration when making your decision.

5. Arrival Check

Once your shoes have arrived, it’s time to check if they’re the right fit. We recommend our usual in-person set of tips, which include:

  • Trying them on in the afternoon to account for natural foot swelling
  • Wearing them with the winter socks your child will wear to school that year, to see if they will still fit well with thicker socks
  • Check both the width and length
  • Check there is still approximately a thumbs width for growth – always evaluate all aspects in both shoes equally
  • Ensure it feels comfy and your child is happy

If your child has any foot pain or problems that are preventing them from running, walking or wearing their shoes comfortably, we’re here to help. Book an appointment with our trusted podiatrists by calling 09 523 2333 or book online here.

Kids Foot Doctor Auckland

Leading children’s foot doctors in Remuera, Auckland

Our team of podiatrists work extensively with children and families to safely and effectively manage a range of foot and leg pains and problems. Aside from being qualified podiatrists, we’re parents too. So we know how it feels to see something unusual and feel concerned, worried, or wonder what repercussions the problem may have for our kids further down the track. We provide every child and family with the very best care, so you feel confident about your child’s outcome and progress.

Treatment for kids foot pain and skin problems

When it comes to children’s feet, their busy and fast-paced nature (paired with their growing and developing bones) means that there are a lot of ways the feet can be affected. We often see and treat:
  • Warts on the feet: plantar warts are caused by a virus and are often spread through schools by sharing the same floors, especially when barefoot such as in swimming areas
  • Growing pains: there’s a common misconception that growing pains can’t be treated and are a normal part of growth. This is far from the truth. The pain experienced in growing pains has a defined medical cause – and therefore a clear medical treatment approach.
  • Ingrown toenails: ingrown toenails occur when part of the toenail grows into the surrounding skin, leading to significant pain and inflammation. This can make it very uncomfortable for kids to walk and play normally – especially in their school shoes.
  • In-toeing and out-toeing: both in-toeing and out-toeing may be normal occurrences in short windows of a child’s life, but can also be pathological (problematic) and lead to problems like regular tripping and falling during physical activity
  • Toe walking: for some kids, toe walking is simply a fun habit. For others, repeatedly toe walking is a sign that the Achilles tendon has contracted in length and it has now become uncomfortable for them to walk with their heel in contact with the ground
  • Ankle sprains: ankle sprains are not uncommon in busy kids, especially when playing games that involve rapid changes in direction. While ankle sprains are often overlooked due to their common nature, treating them is very important in helping to prevent long-term ankle instability.
  • Hammertoes: hammertoes present as toes that are bent at one or more of the toe joints, creating a prominent area that may rub against the top of shoes and create blisters, corns or calluses. While initially toe deformities may remain flexible, they tend to quickly grow rigid and fixed in place, which will persist throughout adulthood.
  • Bunions: we are seeing more early bunions in children, most often linked to either footwear or genetic structural foot characteristics, both of which can be managed when a bunion is detected early, giving time for intervention to slow or pause the progression of the bunion
  • Shin pain: having shin pain is disheartening for kids as it can interrupt their ability to play with their friends, adventure and explore.
  • Knee pain: we see and treat knee pain in kids from a range of causes including growing pains at the knees.
  • Heel pain: while growing pains are a common cause of heel pain in kids, we are seeing more and more instances of other causes, especially those seen in adults as children start to enter more competitive sports at an earlier age.

Children’s foot specialist or doctor?

Our podiatry foot specialists are all registered, experienced and trusted podiatrists that are extensively trained and qualified in assessing, diagnosing and treating children’s foot, ankle and leg problems. We work alongside a large network of doctors who refer their paediatric patients to us for continuing care and treatment.  While many parents initially raise concerns with their GP, like the presence of in-toeing or toe walking, they are referred to our podiatrists because we have the right child-friendly assessment techniques, analysis software (like video gait analysis) and treatment options – such as creating a custom ‘gait plate’ orthotic that is designed to straighten feet. While many of our patients come from referrals from doctors, physiotherapists and other health professionals, you do not need a referral to book in with us.

Kids Podiatry Appointments For Foot & Leg Care

We recommend booking an appointment with our podiatrists if you’re concerned about your child’s walking, running, their feet or legs, or they’re in any pain. We always take each case very seriously and perform a thorough investigation – there is no case that is too small for us to assess and see how we can help. Book your appointment with our Auckland kids podiatrists here. Our clinic is located in the One Health building on Remuera Road, close to Newmarket.

Jolly Jumpers: Are They Good Or Bad?

If you have ever seen a child on a Jolly Jumper (also known as baby bouncers or jumperoos), you might know the look of delight on their face whilst they bounce away. In recent years, however, Jolly Jumpers have come under scrutiny as to whether they may do more harm than good when it comes to healthy lower limb development and reaching developmental milestones.  This is a question our podiatry team is asked every so often, so we thought we’d share some current research and facts about jolly jumpers to help you make an informed decision about what is best for your child.  

Two Sides To Every Story

Research into the use of jolly jumpers as well as walkers does suggest that if they are used excessively, they could alter the pathway of normal development [1][4][5]. While this outcome is not guaranteed and can vary greatly from person to person, studies that compared infants that did and did not use walkers between the ages of 6 and 15 months showed that walker-experienced infants sat, crawled, and walked later than infants who did not use a walker. Walker-experienced infants also scored lower on mental and motor development scales [4], with one analysis showing the walking delay might be up to 26 days [6] On the other hand, a recent analysis of the literature found that more studies and clinical trials showed no developmental delays compared to those that showed the presence of delays [7]. When looking at any research, we must be mindful that many other variables and external factors could affect an infant’s development.  With this in mind, there was one strong message: while some studies did find developmental delays from walker and jumper use and others found no delays, we did not come across any studies in favour of walker/jumper use for improving development in infants.  

Your Child’s Natural Development And Musculoskeletal System

Next, we must consider an infant’s natural development pattern and where a walker or jumper may sit within this. In order for an infant to sit up, crawl and eventually walk, they must develop strength, coordination, balance, spatial awareness and more. With this knowledge, it is not surprising that many do argue that the more time a child is supported in these devices, the less time is potentially spent in positions important to developing these core strengths and abilities, such as tummy time [8]. When placed in a jumping or walking device at a young age and without adequate strength, your child may be unable to control their body and movements while bouncing quickly. This means that their movements could be more random and unrelated to strength development, instead of completing movements that assist in developing their control over their leg and trunk position.  

The Effect On A Baby’s Hips, Ankles And Legs

Jumpers and walkers tend to support a baby’s weight through their hips, crotch and under their arms. This tends to push your baby forwards, which can affect their posture and control of their trunk and legs.  Combining a forward-leaning posture with standing on their tip-toes, can add stress to the ankle joint, calf muscles and the Achilles tendon. This has been reported to contribute to decreased glute muscle use and the potential shortening of the Achilles tendon when excessive time is spent in this position [8]. This concern is discussed extensively by the Australian Physiotherapy Association, who issued a statement over a decade ago stating that baby walkers should be avoided [9]. It has also been suggested that using jumpers or walkers for prolonged periods could increase an infant’s risk of hip dysplasia due to the hip position these devices require, though there does not seem to be significant evidence to confirm this.  

There Is An Injury Risk

Putting musculoskeletal and developmental issues aside, studies do agree and confirm that the rate of preventable injuries from walkers is very high [2][3]. Over 230,000 children aged under 15 months were treated in US emergency departments for walker-related injuries, with over 90% of these injuries being to the head and neck [10]. These findings have led to walker bans in countries like Canada, with sellers risking an instant $100,000 fine.  

What’s The Alternative To A Jolly Jumper?

Tummy time. As stated by health guidelines: “Infants (Birth to one year) physical activity particularly through supervised interactive floor-based play in safe environments should be encouraged from birth. For those not yet mobile, 30 minutes of tummy time… spread throughout the day during awake periods is encouraged.” [11] Tummy time lets your baby continue to develop their core muscles and learn to control their movements. They will feel what it’s like to naturally shift their weight, which is needed to develop the skills required for rolling, crawling, sitting and walking. As each movement is their own, it also helps to build the child’s coordination and motor control.  

And If They Love Their Jumper?

As with most research, there are a lot of factors to consider, and one of them must be what you feel is best for you and your baby. If they are developing well, aren’t at risk of hip dysplasia, and their face lights up when they’re in the jumper, you may decide that it’s best to start or continue using a jolly jumper. In these cases, try to limit their use to 10-15 minutes per day, and only after they can sit unaided, so they have already begun to develop their core strength and skills.   If you’re concerned about your child, any pains or niggles, or their developmental milestones, bring them into our podiatry clinic in Remuera, located at the One Health building on Remuera Road. You can book your appointment by calling 09 523 2333 or book online here.   1 – https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1469-8749.1986.tb03929.x 2 – https://www.tandfonline.com/doi/abs/10.1179/146532806X90637 3 – https://pediatrics.aappublications.org/content/100/2/e1.short 4 – https://europepmc.org/article/med/10533994 5 – https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2214.2001.00186.x 6 – https://www.magonlinelibrary.com/doi/abs/10.12968/bjcn.2002.7.11.10889 7 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703622/ 8 – https://www.abc.net.au/news/2018-10-22/sa-health-recommends-not-using-baby-walkers-or-jolly-jumpers/10403890 9 – https://australian.physio/DocumentsFolder/Advocacy_Position_Baby_Walkers_2007.pdf 10 – https://pediatrics.aappublications.org/content/142/4/e20174332 11 – http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines#npa05  

Seven Signs Your Child’s Feet & Legs Should Be Checked By A Podiatrist

As parents, it’s only natural to be concerned about our children, want them to grow healthy and strong, and want to promptly address any health issues so they can go about their days without being held back by pain or discomfort. When it comes to the feet and legs, however, it can be difficult to know whether what we’re seeing is normal, or whether it could be a warning sign that should be checked. Being parents ourselves, we absolutely get it – so have put together seven of the signs that tell us that a child should have an assessment with their podiatrist to check their foot and leg health.  

1. Pain That Persists, Or Keeps Coming Back

Our body is an extremely complex and sophisticated system that is designed to help us survive and thrive, while keeping us away from danger. It uses pain as our warning sign, that either something is going wrong, or is about to be. That’s why if your child is experiencing pain in their feet, legs or knees, and it doesn’t settle after a day or two and keeps returning with certain activities like sports or running, this is a sign to assess what is going on and get checked by your podiatrist.  

2. Experiencing ‘Growing Pains’

At some point, growing pains became associated with the idea that they are a normal part of childhood and aging, and there was nothing that could be done aside from waiting them out – much like the pain of new teeth breaking through the gums in toddlers. In this case, this is quite far from the truth.  Growing pains have a specific medical cause, occurring when tension is placed onto a growth plate by a nearby tendon, irritating the growth plate and leading to pain and inflammation. We often see this with the tight pull of the Achilles tendon on the back of the heel, where a growth plate is directly located (you can read more about this, known as Sever’s Disease, here). Thankfully, the tension from a tight tendon can actually be eased in a number of ways to help reduce the symptoms, and then give permanent relief.  

3. Interruptions To Sports Or Social Activities

If your child has progressed from being able to spend all day playing, to hesitating, withdrawing or being unable to participate in activities as a result of something to do with their feet and legs, then that’s a sign to bring them in to see a podiatrist. This may be something like having a foot that is in-toeing, making them prone to regular tripping and falling.  

4. Can’t Keep Up With Their Classmates

If your kids can’t seem to keep up with their peers in the same age group, then it is worth investigating to see what could be going on. Many times, it is related to the biomechanics of their feet – meaning how effectively their bones, joints and muscles work together to keep them running and playing all day. When there is an issue with biomechanics or foot posture, it can cause the supporting muscles of the feet and legs to work much harder than they otherwise would, leading to them tiring and aching much faster. This is not uncommon in kids with flat feet among other foot postures. Addressing these biomechanical abnormalities can get muscles working as they should, and help improve your child’s performance, as well as removing any discomfort.  

5. Regular Tripping Or Falling

If your child is tripping or falling over noticeably often, it could be an abnormality in the position of the feet or the way the feet/legs move during gait. It may also be due to a neuromuscular condition where the muscles are lacking the strength needed to clear the ground or function regularly. Through an assessment of the feet and legs, we are able to identify and address the cause to correct the issue and help stop abnormal falls.  

6. Weakness, Instability Or Balance Issues

If you notice that your child’s ankle or knee joints feel unstable or weak, or they’re having issues with their balance, this is a clear sign to bring them in for an appointment. Underlying causes of this can include damage to the ligaments or muscles that result in weakness, muscular imbalances, neuromuscular conditions, and more. As all of these signs have the potential to lead to painful injuries like sprains or falls, and can often immediately be supported with bracing to kickstart their rehab plan, it’s a good idea to bring your kids in for an assessment promptly.  

7. Redness, Lumps Or Bumps On The Feet

If you notice any long standing redness, lumps or bumps on your child’s feet, then that is also a sign to bring them in, as red bumps don’t appear for no reason. They may have corns, calluses or warts that we can treat, the redness could be signs of rubbing from their shoes that we can address, or they may have developed a fungal skin infection. Either way, our experienced podiatry team can help.  

Appointments Made For Kids

We know that it can feel daunting to bring the kids for an appointment where you’re not sure how they’ll react, which is why we go above and beyond to help kids and parents feel right at home with our clinic, and our staff. Our team has built an excellent reputation on delivering exceptional foot care, and loves helping kids be able to enjoy their days without foot pain.    We’re committed to keeping kids happy, healthy, active. Book your appointment with our team online here, or call us on 09 523 2333

Children’s Feet FAQ’s | Ask Your Podiatrist

When it comes to children’s feet, it can be hard to know if what we’re seeing is normal, or if there’s cause for concern. As podiatrists that work extensively with children’s feet, we often have parents bringing their kids in for assessment and starting the conversation by saying “…so I noticed this happening more lately, and it doesn’t feel right to me, but I wasn’t sure…”  If you’re feeling like this – let us assure you that if you’re concerned, or if something feels out of the ordinary, then having a foot health check is the absolute right thing to do. And to help with all of the concerns and questions, we’ve put together a few kids’ feet FAQs for you. If you’re wanting the answer to something specific – just let us know.  

1. Is it normal for kids to have flat feet?

As young children, yes. Their foot muscles are still developing, the fat pads around the feet are more prominent, they’re still very flexible – so having flat feet at this age is not something to worry about in most cases. At school age is when we’d expect to see an arch start to form. Kids are constantly on their feet, their muscles are strengthening and lengthening, their ligaments are growing strong – so it’s common that we’d start to see arches form at this age, by around 7 years old. If arches haven’t developed by this age, there’s a good chance that they may not and your child may have a flatter foot type.  

2. Are there any warning signs that parents should be looking out for at home?

There are a few ‘common’ things we look out for, including:
  • Pain of any kind, including growing pains
  • Children that can’t keep up with their classmates when playing
  • Regular tripping or falling
  • Balance or coordination problems
  • Reluctance to take part in physical activity for no specific reason
  • Hesitation when asked to show you their feet
 

3. Can you fix feet that turn inwards (in-toeing)?

Yes, we work with children with in-toeing using a combination of a specialised kind of children’s foot orthotic designed to straighten the foot, supportive footwear, stretching exercises to loosen tight muscles that may be affecting regular foot function, and strengthening weak muscles to help maintain good foot positioning and alignment. In most cases, we are able to help restore a healthy foot position and function.  

4. Why are my child’s knees so close together?

This is a condition called knock knees (medically referred to as genu valgum), and is often seen in children between the ages of 3 and 5. Walking in this position actually helps kids maintain balance as they develop their walking skills. Knock knees are usually a normal variation of growth and development, and this position is just how some children find their footing. However, this knee position also may be an indicator of an underlying condition such as rickets or osteomalacia. In these cases, knock knees may not develop until the child is six years old, or persist after the age of eight.  

5. I’ve heard we must just wait through growing pains. Is this true or are growing pains treatable?

We’re not quite sure where the old wives tale of nothing being able to be done for growing pains came from, but thankfully it has no scientific backing. Growing pains are caused by irritation of the growth plate – the vulnerable part of your bone that is responsible for bone growth. It is also the weakest part of the bone and is weaker than the surrounding muscles, tendons and ligaments. Pain occurs when muscles pull on the area around the growth plate. By stopping this pull and tension on the growth plate, the symptoms can ease and resolve. This is where we can help.  

6. Is toe walking normal?

Toe walking can be normal, especially in young children who are learning to walk and discovering what their bodies can do. Some kids can find the habit of toe walking to be fun without any issues. Others may be struggling with a shortened Achilles tendon, making it painful, uncomfortable, and sometimes not possible to place the heel in contact with the ground. If you’re worried, get your kids feet checked.  

7. Which school shoes should kids be wearing?

There are several features we look for when selecting school shoes for children. These include:
  • A firm heel counter – this is the part of the shoe immediately behind the heel and often has a stitch or seam in this area. Heel counters should be strong to help control the movement at the heel and ankle, adding stability and helping control the position of the foot.
  • Laces or velcro – the fastenings on the shoe determine how much control you can have over the fit of the shoe, and laces and velcro are preferable as they give the best control. 
  • Good toe box – the toe box is where you check for sufficient room and length, based on the longest foot and longest toe
  • Supportive, removable shoe liners – the insoles that come in the shoe should be comfortable, supportive through the arch, and removable – so that if your child needs orthotics at any point, they can easily replace the current innersole without needing new shoes.
  • Lightweight – heavy shoes can weigh feet down and contribute to tired and achy legs. Opt for lightweight materials where possible.
 

8. Why does my child have warts on their feet?

Warts are caused by the HPV virus, and is often transmitted in childhood through sharing surfaces when barefooted – particularly in swimming areas. For your child to have foot warts, they must have come in contact with this virus at some point in their life.  

9. Can orthotics help kids?

In the right context, absolutely. We use orthotics as part of a treatment plan for a range of children’s foot problems and conditions. Orthotics work by adjusting the position of the foot in the shoe, and therefore changing how the feet and legs work together to produce movement. We don’t prescribe orthotics without a valid clinical reason, however, if your child is suffering from pain, aches or other problems, we will assess if orthotics may be a good solution to help with their symptoms, recovery or future injury prevention.  

We Work Extensively With Children

Children’s podiatry is one of our specialities here at Perform Podiatry. We work extensively with kids and love helping them with a range of foot and leg problems from growing pains to ingrown nails to tired, achy legs. Book your appointment with our experienced podiatrists by calling 09 523 2333 or book online here.  

Helping Auckland Families With Growing Pains

Growing pains are one of the most common pains that we see and treat in kids. While some mistake growing pains for when active kids overuse the muscles of the feet and legs to a point where they are very tired, achy and sore, this isn’t the case. Others have been told that growing pains aren’t treatable and must be waited out or just put up with – which also couldn’t be further from the truth! Growing pains affect children aged between 8 and 16 years and get their name because they can only be experienced while they’re still growing, meaning that these pains can’t affect adults. Most often, but not always, the painful symptoms come on during a growth spurt and while it’s often in kids that are active – it’s definitely not always the case

Understanding growing pains

To understand how and why growing pains can develop, you must know that the way that all our bones get bigger as we grow is through areas in the bones called growth plates. These growth plates, medically known as apophyses, these are the areas to which your body adds new bone. As these areas are constantly in ‘development mode, they aren’t as strong as the surrounding bone, meaning that when the bones are placed under strain and tension (like during exercise!), these growth plates are more vulnerable to damage and the painful symptoms that come with them.

While the bones grow, the attaching muscles grow too

While our bones are growing, so are our muscles – and lengthening to keep up and support them both functioning as a healthy and strong team. While our muscles and bones will ideally grow at a similar rate, at times the muscles won’t keep up and the result will be tight muscles that create a pull on the bone – particularly during running, running sports and exercise. When this tension happens near a growth plate in the bone, the growth plate can become irritated and leave your child with pain and swelling. 

Where do growing pains develop?

The knees, the heels and the feet are the three areas in the body where growing pains affect kids most commonly. We help children effectively manage and relieve their symptoms in all three areas, so they can get back to doing the things they love and not sit out entire sports seasons!

Knee pain – Osgood Schlatters disease

Growing pains at the knees involve the irritation of the growth plate at the top of the shin bone. The patellar tendon, which is the one that runs from the front of your thigh, across the knee and attaches to the top of the shin bone, is the one that tends to create the tight pull and affect the neighbouring growth plate. Symptoms of Osgood Schlatters include pain and swelling when feeling below their kneecap. The symptoms are worsened by running and activities that bend the knee.

Heel pain – Sever’s disease

Growing pains at the heels occur in the very back of the heel, where the growth plate is located, next to the Achilles tendon. As the Achilles is the strongest and largest tendon in the body, if it is tight, it can place massive tension and strain on the back of the heel every time we walk and run. In adults, for some of us it even causes us to lift our heel up early off the ground or be unable to place our heels completely on the ground when the tendon is very tight. In Sever’s, pain is felt at the back of the heel and may radiate or shoot up the leg. There may be some swelling, and your child may limp when the symptoms are in full swing, until they can get some rest.

Foot pain – Iselin’s disease

Growing pains in the feet occur on the outside-middle edge of the foot. Run your fingers along the outside edge of the foot – if you feel a bony bump around the middle, that’s where your child will feel their painful symptoms, swelling and tenderness. It is the peroneus brevis tendon that travels down the outer leg, across the outer ankle, and attaches to that bony bump (your ‘styloid’) that causes the growth plate irritation in this case. This tends to be the least common growing pain of the three – though we still see it in plenty of children every year!

Is your child experiencing pain in their feet or legs?

Pain is never a normal part of growing up – it’s always an indication that something is wrong – and in most cases, this something can be treated when it has a clear cause – which it definitely does in growing pains. Often, there are a number of factors that contribute to the increased strain from the muscles and tendons – including the structure and function of the feet and legs, footwear, the way they walk, muscle strength, and more.  We’re parents too – and we understand how important it is to get the very best care for your child – and that they can enjoy the experience too! Our podiatry team starts each appointment by understanding exactly what’s going on and causing the pain – and then puts the right care in place to both treat your child’s current symptoms and to prevent the problem from recurring in the future. We’re here to help. Book your appointment online here or call us on 09 523 2333

Treating In-Toeing In Kids

The position of your children’s feet can either keep them free to run and play, or encourage them to trip, fall and result in pain. In-toeing affects many kids as they learn to walk confidently. At a young age, in-toeing may not be an issue – as long as it doesn’t cause other problems and pains. When in-toeing continues into the primary school years, it could indicate that it’s not going to resolve on its own- and help is needed to prevent it from continuing into adulthood.

So why does in-toeing develop and what can you do about it? Today, we share our easy and effective solution to correct in-toeing in kids: the gait plate. 

In-toeing: Quick low-down

In-toeing, which is often referred to as pigeon-toeing, can affect both children and adults alike – although adult in-toeing is usually a result of childhood in-toeing not being treated. It’s very easy to spot because of the inward rotation of the feet.

While it may appear like a funny or wobbly walk, the reality is that in-toeing:

  • Can cause tripping and falling (and hence painful injuries)
  • Indicates an irregularity within the structure or positioning of the bones of the lower limbs
  • May be a precursor for further problems and pains

It is typically caused by one of three ways:

 (warning, we’re about to get technical here)

Metatarsus Adductus describes the inwards curve of the forefoot (toes) on the rearfoot (heel). This may be described as a ‘banana-shaped’ foot and is thought to be a result of the position of the baby in the womb, so is typically present at birth.

Tibial Torsion is the inward rotation of the shin bone, otherwise known as the tibia. Because the tibia is turned inwards, so is the ankle and foot, resulting in in-toeing. Here, correcting the position of the shin bone will correct the in-toeing.

Femoral Torsion is the inward rotation of the thigh bone (femur). This also rotates the shin bone and the foot, causing in-toeing. You’ll often notice the knees turn in to face one another, too. This is one of the reasons that children are discouraged from sitting in the ‘W’ position – because it rotates the thighs inwards.

Introducing the hero solution: The gait plate

A gait plate is a special type of orthotic that encourages the feet to turn outwards and hence straighten with every step in the shoe and orthotic. It is designed very specifically to the landmarks of a persons’ foot, which is captured with a cast impression following a comprehensive assessment. It works by encouraging the outward rotation of the feet with every step. The orthotics replace the liner of your child’s shoe, and can be moved from shoe to shoe. The best part is – kids can’t even tell that they’re there!

That means no tears and frustration (for both kids and adults!), just pop your shoes on and go.

Worried about the way your child is walking?

We’re parents too – and we’d love to help. To book in with our experienced podiatrists, you can call us on 09 523 2333, or book online here.

Auckland School Holiday Activities 2020

School holidays are here and that means one thing: frantically finding activities that ditch the screen time and embrace the outdoors! 

We’re parents too, and we (like many others) are seeking (physical) activities that will also ensure the kids will have a good, long sleep. We found a good bunch for our kids here in Auckland – so thought we’d share them with you too so you *may* be able to enjoy finishing a cup of hot coffee for the first time in years. Disclaimer: We haven’t managed it just yet.

Sculpture in the Gardens

This is an exhibition hosted at the Auckland Botanic Gardens and is now open daily (8am – 6pm) to the public for this Summer right through until Sunday 1st March, 2020. This 2km sculpture trail is absolutely free (yessss) and a great opportunity to get out and about to let the kids explore and complete activities as you all walk around admiring the large scale artworks. While you sip on a hot takeaway coffee. You can find more information here https://www.sculptureinthegardens.nz 

The Enchanted Walk

The Enchanted Walk in Alberton on Mt Albert Road is another goodie. Walk around the pathways looking for all the hidden fairy doors and houses dotted throughout. Complete with a bring and swap painted stone garden, this will provide lots of fun for the whole family (because the kids will love it, and you can relax and snap some great pics of the kids to give to your parents for Christmas). Open 10.30am – 4.30pm, Wednesday to Sunday through until the end of February 2020. Find all the information you need here https://www.neighbourhoodarts.org.nz/the-enchanted-walk 

Splash Pads

Splash Pads are such a hit during the hot summer months in our books too! Great opportunity for the kids to get out and run around, cool down and have a whole lot of fun while doing so! A great list of some of the best ones in Auckland can be found here https://www.aucklandforkids.co.nz/playgrounds/the-best-splash-pads-in-auckland-for-kids/

Climb to the summit of Rangitoto Island

We like this one because ferries + picnics + walks + views = great family day out! We plan on doing this one with friends that also have kids – and are looking forward to it! For information on ferry crossings and how to get around once you are there, find the Rangitoto Island website here http://rangitoto.co.nz

Local bush walks

There are so many goodies in the Auckland area, so you don’t have to drive far. We plan on showing the kids some photos of things they may find in the forest, so they can look for them and hopefully appreciate the little details of what our beautiful country has to offer! We love this curated list of walks that we found here:  http://epiclittlemissions.co.nz/auckland-walks-short 

And some more!

We loved finding this list of activities to do these school holidays, but we won’t be forgetting our good-old-faves, such as:

  •  Heading to the Auckland Zoo for a day out. Aaaand it has a South East Asia Jungle Track opening soon!
  • Exploring the Auckland Museum, the Auckland Domain and the Auckland Wintergardens – just keep an eye on the kids around those geese!
  • Finding new awesome playgrounds. In our books, it’s an easy winner! https://www.aucklandforkids.co.nz/top-10-playgrounds/

And if your kids have any pains or niggles this summer…

… Bring them in to see our experienced podiatrists! We love helping kids stay happy and healthy on their feet. You can book your appointment online here or call us on 09 523 2333

In-Toeing & Out-Toeing: Should My Child’s Feet Be Pointing That Way?

Kids are constantly surprising us as they grow. They learn quickly, are constantly developing, growing and getting stronger – and not to mention wiser! But how do we know what is and isn’t normal when it comes to their feet and legs? This is a question we get asked a lot here at Perform Podiatry. Especially when it comes to feet that are pointed inwards or outwards! Unfortunately, there is no one right answer, as it very much depends on the age of your kids and any other symptoms they may be experiencing. To help you better understand what’s going on and if what you’re seeing may be concerning, here’s our low-down on in-toeing and out-toeing for kids. Note: If you’re an adult that is significantly in-toeing or out-toeing, that typically isn’t ‘normal’ and may be having consequences on your bones, joints and the rest of your body. If that sounds like you then we highly recommend coming in for an assessment with one of our expert Podiatrists.

Out-Toeing

Out-toeing describes the outwardly turned position of the feet that is sometimes referred to as ‘duck feet’. Out-toeing is less common than in-toeing, but it can be more serious if it doesn’t resolve. Out-toeing can be caused by:
  • The outward rotation of the femur (thigh bone)
  • The outward position of the hip (present at birth)
  • The outward rotation of the tibia (shin bone)
  • Flat feet (which make the feet appear to point outwards)
Out-toeing should resolve on its own by the age of eight years old. If your child experiences pain at the feet, legs, knees or hips, we highly recommend bringing them in to assess if they need early intervention to help resolve their pain and problems. Other warning signs to look out for include regular tripping, falling and not being able to keep up with kids the same age when it comes to physical activities.

In-Toeing

In-toeing describes the position where the feet are turned inwards to face one another when walking. It is often referred to as being ‘pigeon-toed’. While variations in foot position is not uncommon for young children, the in-toeing should resolve by the age of five years old. If it doesn’t, this is an indicator that the feet may need some assistance in straightening. In-toeing can be caused by:
  • Metatarsus adductus, which is a bean-like shape of the foot present at birth (approximately affecting 1 in 1000 births)
  • The inward rotation of the femur (thigh bone)
  • The inward rotation of the tibia (shin bone)
While in-toeing itself does not usually result in any pain, it can cause tripping, falling and may contribute to knee, hip or other lower limb pain. If any pain is present or you notice your child often tripping on their feet, we highly recommend that you bring them in for an assessment.

How can these foot positions be treated?

If the out-toeing or in-toeing does not resolve on its own, we’re able to implement techniques to help encourage the feet to straighten. This can be done through:
  • Orthotics that are custom-designed for the specific foot to encourage it to turn inwards or outwards respectively to straighten
  • Strong, supportive footwear that will help stabilise the new position of the foot
  • Stretching exercises to loosen tight muscles that may be affecting regular foot function
  • Strengthening weak muscles to help maintain good foot positioning and alignment
If you’re unsure, we always recommend bringing your kids in for a foot health check and making sure they’re on the right track! Our team at Perform Podiatry love working with kids and helping families stay happy, healthy and active! You can book an appointment by calling 09 523 2333 or booking online here.