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Children's Devoplement - What is normal?

Having a child can bring on worry about what is normal and what is not. Especially as they move from crawling to taking those first steps. This blog will look at a few key reasons that we see parents presenting to the clinic and also what are some of the things that we would recommending getting checked out.

A favourite fact is that babies are not actually born with all the bones in their feet that they will eventually have an as adult. Quite often we see small children in the clinic because their parents are concerned that their child has flat feet. If if you think about the bone

structure it is pretty hard to have an arch without all of the bones present. Children will often develop an arch around the time that they start school.

There are a few things that can be of concern with children and flat feet but that will be discussed further in.

Another common concern of parents is the presences of "Knock knees" or "bowed legs". When children start walking it is normal for them to have a waddle like appearance, it may look like there knees are too far apart but this is very normal. As you can see from the diagram below a child will go through a range of presentations of leg positions throughout their life time.

Toe walking can be another issue that parents worry about with children. This can be linked with children having sensory issues, where they do not like the feeling of the ground on their feet but there are also other reasons children can walk on their toes. They may have just had a growth spurt and now they can see things on top of a table that they could not before, they could now be able to reach different things and finally children love to experiment with the ways in which they move their body when they gain a new skill such as a walking, it is not un common for them to do walks where they are doing little shuffles or walking backwards.

In toeing is another concern that parents can have. This is when the child toes point in towards each other. There are 3 main causes of this when the foot is turned inwards, when the lower leg bones are turned inwards or if the thigh bone is turned inwards. As with most things effecting children monitoring is the first step. A podiatrist can talk to about sitting and sleeping positions that may be also be playing a roll.

When some children are born the last few toes can curl under the first few. This is called curly toes and is because of the positioning in the positioning of the feet in the womb. In most

children this just resolves itself with time but for a small few they may need intervention. The most important thing for these children is to have shoes that have enough room in the toe box of the shoes to provide room for the curled toes to help avoid rubbing or blisters.

Footwear enquiries by parents are very common in the clinic with parents wanting to know when to put their child in shoes and what type of shoes. When a child first starts walking the aim of footwear is protection. From the cold, heat and nasties which may be on the ground. When a child first starts walking having a flexible sole of the shoe is important to help with the development of the muscles in the feet and lower legs. If the child does not need protection from the elements then barefoot is best, unless a medical professional has told you otherwise. If we link footwear back to a child's development then we can see the need to ensure that their footwear is wide enough as they often have flatter feet to start with, if a shoe is not wide enough they may experience rubbing and the formation of blisters.

If you are concerned about your child's gait or foot position there are a few things that you can look out for they may indicate that you need to seek help.

  • Asymmetry- so if one side is different to the other.

  • Fatigue- if you notice that your child is unable to keep up with their peers.

  • Pain- crying when trying to walk or rubbing legs or shoe refusal could be a sign that your child is in pain if they are unable to communicate with words yet.

  • Tripping alot - unable to perform tasks

  • Toe walking all the time or if they are unable to put their heels on the ground when walking.

  • Still having flat feet around the age of 5.

  • Skin or nail changes from their toes curling under.

If you are unsure it is always handy to take photos or videos of your child to show your podiatrist as sometimes children do not want to perform a skill in the consult and this way we can see the concern over a period of time.

If you have any concerns about your child the clinic has free paediatric assessment on Friday morning between 9am and 10am. During this consult we assess your child to see if they require intervention or a longer consult for further assessment. If you would like to enquire give the clinic a call on (03) 8648 7678 or drop in to see the Foot Body Sole Team at 108 Bridport St Albert park.

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