Parents are often concerned with their children’s feet or the way they walk or run. In many cases these concerns are part of normal development and a “watchful waiting” approach is advised. However, if your child experiences pain or discomfort, has frequent trips or falls or if you would like the reassurance of a professional assessment and opinion, then please see a podiatrist or relevant health professional. There are a number of places to seek help in Perth listed later in the article.
Please note that the following information regarding common foot conditions seen in young children is intended as a general guide and is not to be used as a substitute for medical or podiatric assistance.
Flat Feet A flat foot is where there is no arch visible when a person is standing. Most infants and young children will appear to have flat feet due to flexible joints and ligaments and because the baby fat pad hides the developing arch. Most children will develop an arch when their feet are in a standing position by the age of around 6 years. Flat feet are very common and tend to occur in other family members, and although they can cause pain and lead to other problems such as shin splints, tendonitis and knee pain, in many cases they do not cause any issues.
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Signs to look out for are if your child complains of “tired feet”, frequently wants to be picked up because their feet are sore or struggles with running and sports. In these cases an assessment with a podiatrist is recommended. Appropriate footwear and insoles/orthotics may form part of treatment if it is required.
Appropriate and well-fitting footwear is a keystone of managing many foot problems
Knock Knees Knock knees are often part of normal development. From birth to about 2 years of age, children will have “bow legs” as a normal part of development. At around 2 years of age, the knees and legs will straighten to a normal position. From the age of around 5 to 6 years, the knees and legs will develop into a “knock knee” position, which normally straightens again between the ages of 6 and 12 years. At around 12 to 14 years, the knees and legs will again develop into a “knock knee” position before straightening into a normal adult position from around the age of 14. Most cases of knock knees are a normal part of development and do not require treatment, however, severe cases may benefit from a referral to a paediatrician.
Pigeon Toe Pigeon toe is where the feet turn in when walking. It can be a normal part of development and may reduce over time. A skew foot can also make the feet look like they are turning in. Pigeon toe can make a child look awkward when they walk or run. If it causes frequent trips, falls or stumbling or appears to affect their ability to run and play, then an assessment with a podiatrist is recommended. Insoles or orthotics may be required in some cases.
Skew Foot Skew foot is a common condition where the outside border of the foot is normally straight with the foot curving inwards. It is thought to occur due to the position of the baby in the mother’s uterus. In most cases the condition is flexible and improves without treatment by the age of 2 or 3, or may be improved by gentle stretches and exercises. Severe cases should be identified soon after birth and may require a short period of casting. Some cases may require insoles/orthotics or special footwear to assist with treatment.
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Curly Toe Curly toe is a condition where the toes can curl under because the tendons are too tight and pull the toe over out of place. It is present from birth and is hereditary, so have a look at your own toes! It may become more noticeable as the child begins to walk. It often improves without treatment as your child grows and develops. Wearing shoes that are not too tight may also be helpful. If the condition causes pain or discomfort and persists beyond the age of 6 years, then a simple surgical procedure that can be done under local anaesthetic to cut the tendon to improve the position of the toe may be considered.
Curly toe in a young child
Toe Walking Toe walking is when healthy children persist in walking on their tiptoes after they should typically achieve a heel to toe walking pattern. It commonly affects boys more than girls and does not usually cause pain. If left untreated, toe walking may lead to a higher chance of tripping or falling and can have a social impact as the child noticeably does not walk “normally”.
Parents are encouraged to seek advice from a health professional when toe walking persists. Toe walking may result from an underlying condition such as cerebral palsy, muscular dystrophy, club foot, autism spectrum disorders and in children with intellectual disabilities. Once these conditions are ruled out, persistent toe walking in healthy children may be due to tight Achilles tendons, limited ankle movement, use of infant walkers or it may be hereditary.
In many cases, the condition will correct itself once the child is aged between 3 and 8 years, therefore a “watchful waiting” approach may be recommended. This can be assisted by applying gentle pressure on the child’s shoulders and verbally reminding them to put their “heels down”. For serious and persistent cases, treatment may involve muscle stretching exercise programs, footwear, orthotics, serial casting, Botox injections and/or surgery to lengthen the Achilles tendon.
Where to seek advice and treatment
Child State Development Centre The Child State Development Centre holds podiatry clinics for children on Monday, Wednesday and Thursday mornings. Monday clinics alternate between their main West Perth clinic and a satellite clinic in Mandurah. All bookings are made via the West Perth office. To make an appointment, you will need a referral from a health professional. Assessment and advice only is provided – no orthotics or treatment is provided. Patients are referred on to other services for treatment if required.
Essential Information Address: Child State Development Centre, Rheola St, West Perth
Mandurah Community Health and Development Centre, 112 Lakes Rd, Mandurah
Phone: 9426 9480
You do not need a referral to see a private podiatrist. Rebates may be available if you have private health insurance. A typical appointment may include taking a birth history, developmental history and family history. Assessment may include testing reflexes, checking the range of motion of the hip, knee, ankle and foot and watching your child walk or play. Treatment may include providing appropriate education, exercises and stretches to do at home, footwear, insoles/orthotics and/or referral to an appropriate health professional such as a physiotherapist or paediatrician.
Most podiatrists are experienced in the assessment and treatment of children’s feet. Johan Steenkamp at JS Podiatry is particularly well experienced in dealing with children’s foot problems.
Essential Information JS Podiatry
Address: located within Spine and Sports Centre, 17 Wittenoom St, East Perth
Phone: 9221 8458
JS Podiatry in East Perth
Well-fitting, appropriate shoes are a keystone of foot health. Magic Shoebox is owned and operated by Perth mum and podiatrist Kath Lloyd who is proud to stock a range of quality footwear for children supported by an innovative, expert fitting process.