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Worried About The Way Your Child Is Walking?

“And what is the problem that your daughter is having with her feet?”

“She’s walking funny. I don’t know if it’s normal – it doesn’t seem quite right”

That right there is a conversation that our receptionist has on the phone many times a week. Parents notice that something isn’t *quite* right with the way their kids are walking, and aren’t sure what they should do. Primarily, they don’t know if it’s a normal part of their kid’s growth and development – or whether something isn’t right and their kids may be vulnerable to problems down the track.

This is a very real concern – and as parents ourselves, we want to help. So today, we’re sharing five common problems we see in kids with the way they walk – and what it means for their foot and leg health.

1. Toe Walking

Toe walking describes walking regularly on the balls of the feet, without the heel coming into contact with the ground. It is not uncommon to see this up to the age of three, where kids are still very much exploring walking styles and learning what feels comfortable for them.

Toe walking before the age of three isn’t an indicator of a problem – kids may just be having fun walking this way. It may become a problem if the frequency of this walking style is so high that muscles adjust to this position. As the Achilles tendon remains contracted when on the toes, if it becomes permanently contracted, then kids may have no choice but to continue walking on their toes as attempting to make ground contact may become uncomfortable or painful.

If your child is toe walking beyond the age of three, or they are complaining of any pain or discomfort while toe walking, we recommend bringing them in for an assessment.

2. In-Toeing

Often referred to as pigeon-toeing, in-toeing is the position where the feet turn it to face one another. While the position itself is not typically painful, it can cause kids to trip over their feet and fall more often, leading to other injuries. It may also make them appear clumsy and uncoordinated.

When in-toeing persists beyond the age of four, it’s important to find out the cause. If in-toeing is not present at birth and develops, it is likely caused by the internal rotation of either the shin bone (tibia) or the thigh bone (femur). In this case, it is not just the foot that is affected, but the muscles around the legs, as well as the knee joint.

We’ve been working with a lot of cases of adult in-toeing lately – that is, in-toeing that never resolved in childhood and has persisted into adulthood. While some in-toeing may resolve over time, in others it can persist. If your child is in-toeing past the age of four, bring them in for an assessment.

3. Flat Feet

When your child is first born, they’ll likely have flat feet – and this is completely normal. Their feet will have a big fat pad and no strong, defined foot muscles yet – so don’t worry about whether an arch is forming until your child is at least a couple of years old.

As kids grow and become confident and strong walkers, we do expect that an arch will start to develop. Around the age of four to five is when we’d expect to see a ‘normal’ arch. If it hasn’t developed by the age of five, and they’re not exhibiting any painful symptoms in the feet or legs, then it is likely that they have a flatter foot posture. This means that they may not develop any more of an arch as they grow.

For some children, they may exhibit few symptoms of their flat foot type, other than some tired or achy legs on days that they’re very active on their feet. For others, however, their flat foot posture may make them vulnerable to foot and leg problems. Specifically, they may sustain more overuse injuries as a result of their muscles working harder to support their feet.

If your child still has flat feet at the age of seven, or they develop any pains or aches at any age after they start walking, bring them in for a foot health check.

4. Knock Knees

Knock knees describe the position where the kneecaps turn in to face one another, bringing the knees closer together (and often the feet wider apart). While knock knees around the age of three or four may be a normal part of the development process, they should resolve by the age of seven.

While kids are still young, their knock knees may help them to feel more stable and balanced on their feet. However, when they start to run quickly and participate in sports, knock knees may cause them to trip and fall, injuring themselves.

If knock knees persist beyond the age of seven, or only develop around the age of six, bring them in for an assessment. This will also help rule out any underlying disease.

5. Limping (or other exaggerated hip movements)

If your child starts limping and is in pain, bring them in straight away. If they appear to be limping (or strangely moving their hips or legs) and are not exhibiting any painful symptoms, there are a number of possible causes that we recommend investigating. These include a leg length difference, hip muscle weakness, juvenile arthritis, neurological problems and more.

In these cases, we always recommend an assessment as the safest precautionary measure because limping (or exaggerated hip movements) are not a part of regular growth and development in kids.

Need To Book In With A Children’s Podiatrist?

We love helping kids and families get back to being happy, healthy and feeling great on their feet. We work extensively with children in the Auckland region and have a family-friendly clinic for kids to enjoy. We’re parents too – so we completely understand your fears and concerns.

You can book your appointment online here or call us on (09) 523 2333

Why A Diabetic Foot Check Will Literally Save Your Feet!

Diabetes is a condition that affects a LOT of us New Zealanders. Five years ago, it was estimated that it affected around 300,000 of us (both diagnosed and undiagnosed), and undoubtedly this figure has continued to grow since then. When most people think diabetes, they think of blood sugar levels. But what does this have to do with the feet and why is your Podiatrist so important when it comes to diabetes? Let us explain.

Feet are often the first to suffer the consequences of diabetes

That’s right. Being the furthest away from the heart (with the longest blood vessels and nerves to reach the ends of the feet), the feet are prone to incurring damage from the effects of diabetes. There are two main ways that diabetes affects your feet:

Abnormal sensations (and loss of sensation) in the feet
Decreased blood supply to the feet

Abnormal sensations in the feet

These unusual sensations can range from burning, numbness, tingling, pins and needles, mixing up hot and cold or sharp and dull, and more. This occurs because of the damage to the nerves that occurs in diabetes changes the way your body interprets physical sensations. The most dangerous of these, is just the absence of feeling in the feet. Here, we’re not talking about a numbness, but a complete absence where you don’t even realise that you’ve lost the ability to feel. The risk here is that you sustain an injury – like a cut or standing on something sharp, and then are unable to feel it. If you can’t feel it, then you don’t know to move your foot and clean/dress the wound, and it becomes vulnerable to infection and ulceration. If infections linger long enough untreated, they can spread to the bone. This is known as osteomyelitis. Osteomyelitis is very serious and difficult to treat, and is a major reason that diabetic ulceration is the leading cause of amputation worldwide, other than from trauma/accidents.

And when the blood supply decreases

Damage to the blood vessels as a result of diabetes also means less blood to the feet. Decreased circulation means your ability to repair wounds and damage decreases – and so does the ability to fight off the aforementioned infections.

So what difference does a foot check make?

A diabetic foot screening examines your sensation and circulation around your feet to determine your risk level for serious complications. Aside from having your feet thoroughly examined by a professional for any signs that something is going wrong, you’ll know exactly what’s going on, what stage you’re at (as the effects of diabetes gets progressively worse), what you should be looking out for and what you do if something goes wrong. It may seem like something so simple and routine, but the consequences of not having your feet assessed regularly if you have diabetes can be severe, so just like your regular dental appointment, make sure to put it in the calendar. If you have diabetes and are worried about your feet, we’d love to help! You can get in touch by calling us on 09 523 2333 or booking online here.

Ingrown Toenails: Why it’s time to throw out the home remedies!

We have the pleasure of seeing and treating a lot of ingrown toenails. That’s not sarcastic at all – successfully treating ingrown toenails provides an immense amount of relief to suffering patients and using our skills to do this successfully is something we’re very proud of. There’s a common theme to many of the first visits we have with our patients, however, that we thought we’d shed some light on in case you happen to find yourself in this boat too. This theme is the I-googled-it-so-it-must-work home remedies for ingrown toenails. Now, don’t get us wrong. Some of the strategies you try may well alleviate your pain and have you feeling much better. There’s almost always a catch though: It’s temporary.

Repeated ingrown toenail occurrence

The unfortunate truth is that if you’ve suffered from the terrible pains of ingrown toenails more than once, the reality is that you’re almost definitely going to suffer from them again. One-off ingrown toenails absolutely do occur, but the cause is usually a particular pair of tight shoes that push the nail into the skin and they don’t tend to occur again after you’ve stopped wearing them. Repetitive ingrown toenails are the best indicator that there’s something going on, that the nail has now started growing in an abnormal way that ends up penetrating the skin, and that it’s going to continue to happen.

So, why advise against home remedies?

The first reason is that without knowing exactly what you’re doing, you could be further encouraging the nail to continue to grow in a way that will cause you a tremendous amount of pain. Take the way your nail is cut, for example. If you think that cutting down into the corner and removing the piece of nail will discourage it from growing there again – the reality is the exact opposite. Curving down and removing that painful nail edge will likely encourage the nail to keep curving a growing down – unless you know what you’re doing and understand the characteristics of nail growth. The second reason is that as health professionals, we don’t want you to suffer with ongoing pain. Experiencing pain every 3 months from an ingrown toenail isn’t a great solution in our opinion, and especially not when you can have a one-time permanent procedure that will have you saying goodbye to ingrown toenails for good.

So, what is this procedure?

The procedure we’re talking about is called a partial nail avulsion (PNA). It involves removing a small part of the nail (the part that causes you pain!) and applying a chemical that will stop that small portion of nail from growing back and continuing to cause you grief, over and over again. We love this procedure because:

It’s done simply and effectively in-clinic
It’s completed in 60 minutes (with the procedure time typically around 20 minutes)
It’s performed under local anaesthetic so is pain-free
You do not need to take any additional time off work/school following the procedure & can go home immediately
You don’t need any special boots or braces while the toe heals
The procedure causes very little post-procedure discomfort
We dress your toe, provide you with a take-home dressing pack & re-dressing instructions
We monitor your progress to ensure it’s healing well

While we perform conservative one-off care for first-time ingrown toenails or those with a definitive cause that is not likely to recur, the PNA is our best recommendation for those that are repetitively putting up with and suffering from ingrown toenails. We have tremendous success with the procedure and have prevented hundreds of patients from continuing to regularly suffer. Our team are experts when it comes to ingrown toenails and we love seeing the difference that having this procedure makes in the lives of our patients. For more information about the PNA procedure, click here. To book an appointment, you can give us a call on 09 523 2333 or book online.

Stop Athlete’s Foot This Summer!

Summer is here (yay!) and that means sunshine, warm days and spending lots of time outdoors. This is also a time where we do see a lot of patients with Athlete’s Foot, which is clinically known as tinea pedis. There are two main reasons that we see if often around now: (1) is that fungus thrives in warm, moist conditions – and it’s pretty warm outside so our feet tend to sweat, and (2) is that because we wear more open-toed shoes, those that have been hoping that it’ll settle and resolve over the winter are now starting to feel a little more self-conscious and decide that it’s time to take action. Either way, or whatever your reason, your Podiatrist is definitely the right place to get rid of it once and for all.

So, what exactly is Athlete’s Foot?

Athlete’s foot describes a fungal skin infection that is actually relatively common. It’s common because it’s very contagious and it only takes sharing a shower or a surface (especially gyms, locker rooms and anywhere warm and damp) to become infected yourself. If it infects the nails, it can become very difficult to manage.

What are the symptoms?

If you have contracted Athlete’s Foot, you’ll experience:

Itching
Red scaly patches on the skin of the feet that seems dry
Stinging or burning
Breakdown of the skin between the toes that may present as cracks or fissures

How do you treat it?

The first step in managing and eliminating Athlete’s Foot is to have a correct diagnosis from your Podiatrist. Once you’re sure it’s a fungus, you should be doing as much as you can to keep the feet dry, clean, and away from sources of infection. These typically include:

Keeping the feet dry
Using absorbent powders if your feet sweat excessively
Disinfecting infected shoes and socks to demote reinfection
Wearing absorbent socks that will promote a dry environment
Wearing open shoes where possible to let the feet air and dry

To treat the fungus directly, your Podiatrist will recommend the right anti-fungal for you to use. This may come in the form of a cream, powder, tablet or other medication. This is best decided by your Podiatrist and pharmacist as oral medications can take a toll on your liver, so must be carefully assessed with regard to your overall health. If the infection has spread to your toenails, you’ll also need to treat the nails too. This can often be significantly more difficult than treating the skin alone as the fungus can penetrate the nail bed. Your Podiatrist will advise you on the best course of action for this. Throughout your treatment, care must be taken as the infection can make your skin very fragile and susceptible to damage.

Will the infection come back?

Because fungus spreads so easily, care must be taken to avoid re-infection. This doesn’t necessarily mean picking up an infection from someone else, but also re-infection from wearing your own infected shoes and socks. Your Podiatrist will run through with you the best ways to minimise your risk of re-infection and to keep the fungus gone. This can include anything from scrubbing down your showers with appropriate agents to hot washing all of your socks, bath mats and shoe liners with an anti-fungal washing detergent. If you’re battling a fungal infection of your skin or toenails, come in and see our expert team at Perform Podiatry. Worrying about your fungal infection shouldn’t be a part of your summer! Give us a call on 09 523 2333