THE PEDIATRIC FOOT

Dr Federica Papolino – 08 January 2020

Since the first years of life the foot works with the rest of the body and the right attention must be dedicated to it. Possible problems with this important structure may cause deambulation disease. Taking care of your foot wants to adopt a series of behaviors that range from daily hygiene up to the use of the sector specialists ‘tips

LET’S KNOW THE FOOT!

The foot for children is an exploratory probe of the floor and a source of information for balance and walking abilities. It is essential to remember that the child must choose the time and style of the walk by himself because this can help us identify any walking defects. It is advisable, as much as possible, to let children walk barefoot, at home or even better outdoors on grassy or sandy ground, this is, in fact, a very useful exercise to strengthen the sole, to train the muscles leg and to educate balance.
The baby’s foot is constantly evolving and its defects in most cases are destined to correct itself spontaneously during growth. Despite this, preventive checks should be carried out around 3-4 years of age to be able to identify skeletal conditions or prevent posture defects.

AMONG THE MOST COMMON FOOT DEFECTS, WE INCLUDE:

FLAT FOOT

It is characterized by the absence of the arch, i.e. the hollow that the sole of the adult foot has on the internal side. In practice, the footrests on the ground with the whole plant, often the ankle seems to give way inwards and the heel appears deviated laterally. In the small child, it is the rule, both because the plantar arch is full of subcutaneous fat and because the ligaments and muscles of the foot are not very efficient.

Up to the age of 5 it is physiological, later we could take several measures.

Parents must pay particular attention to the footwear which will be deformed and worn on the side of the sole or the inside of the heel.

Functional improvement can be obtained through orthotic insoles accompanied by functional recovery exercises for 1-2 hours a day such as walking on uneven ground, walking on toes or heels, marching on the outer edge of the foot, collecting objects with the fingers of the walk and ride a bicycle. Periodic checks are also recommended.

CLAW FOOT

It is a malformation of the plantar arch. The footrests mainly on the heel and forefoot, and it is accompanied by contracture of the leg and foot muscles.

The shoe is generally worn on the outer edge, the child reports pain in the forefoot, leg, and difficulty in motor activities. Functional improvement can be obtained through orthotic orthoses, accompanied by stretching and muscle stretching exercises and periodic checks.

CLUBFOOT

It is a congenital deformity that occurs in different clinical forms characterized by a variation in the normal relationship between the longitudinal axis of the foot and the leg so that the foot does not rest on the ground regularly. It is treated early through correction maneuvers, the use of repeated plaster casts and appropriate footwear, allowing for a normal relationship life in the future. These children are followed in recovery by a multifunctional team including the podiatrist.

SOME TIPS: BE CAREFUL AT HOME!

  • Observe how he wears shoes
  • Examine the footprint left by the wet foot on the floor: after 4-5 years there must be a central vacuum, otherwise, there could be a risk of flat feet
  • Examine the baby’s feet when his legs are dangling, in this relaxed position it is easy to detect the tendency to hollow foot
  • Have the child perform a regular motor activity

THE RIGHT FOOTWEAR:

  • it is comfortable and guarantees the right movements
  • it has a flexible sole
  • it has an adequate length: it should go one finger across the big toe as the foot during the step moves inside the shoe and slides forward: if it is too short it would cause continuous microtraumas to the fingers; if too long it can lead the child to incorrect postural attitudes
  • it has a solid and resistant buttress that does not exceed the height of the ankles

WHY SHOULD I GO TO THE PODIATRIST?

The podiatrist intervenes in the child’s nail education and in any pathologies that may arise (plantar warts, ingrown toenails, flat or claw foot, congenital clubfoot).

Walking, for podiatrists, is the best of the exercise!!!

Periodic visits, regular podiatry care of the foot and collaboration with parents can highlight defects and conditions for which immediate treatments or visits in collaboration with other specialists are necessary in order to improve future life.