The Development of Foot Problems in Children

It is an obvious cliché that children are not just small adults. The growing child has developing bones and other body systems that mean that the nature of orthopaedic problems that children get are unique to children and are not like the ones you would expect in a small adult. As the child is growing, there are specific problems related to that. The growing tissues are more likely to be damaged if they are subject to injury. The foot is one part of the body that is not only growing in the child, it is also subject to potential injury and trauma as well as pressure from the footwear, so there is lot that can go wrong with it.

One of the challenges in treating foot problems in children (and a lot of other problems in children seen by health professionals) is determining what is abnormal and what is a part of normal development. Within podiatry, one of example of this dilemma is that of flat foot. A flatter foot is part of the normal development of the child so it can be difficult to decide if the flat foot is something not to worry about and wait for normal development to occur or if it is potentially a problem and needs to be treated. There are a lot of differing and strongly held opinions on this as to if it should be treated or not. To complicate this even further is that most adults with a flatter foot do not have any problems, which adds more to the debate if this should be treated or not.

Also crucial in this population is the monitoring of the development of gait and the achievement of neurological milestones. Parents are obviously concerned if there are any delays in achieving certain milestones in a timely manner and often seek the help of health professionals if they perceive any difference. There are a wide range of clinical tests and observations that clinicians use to assess the developmental status of children and how well that development is progressing. Any delay could be nothing more than a natural variation in normal and be nothing to be concerned about. However, it also could be the first sign of a potentially serious problem that needs to be monitored very carefully or have treatment started as soon as possible. It an often be a fine line between something being abnormal and being just a normal variation in development. The skills of a team of competent health professional is often needed to reach agreement on the best step forward on this issue.

A podiatrist with expertise in paediatric foot problems is Dr Cylie Williams PhD. Dr Williams has been a guest on several episodes of the podiatry related livestream, PodChatLive, that goes out live on Facebook and the recorded version is on YouTube and the audio version is on all the usual podcast sources. In those episodes all of the above issues were discussed in detail, especially the need to get the diagnosis correct and to follow the evidence based guideline to manage the foot and lower limb problems.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.