Pediatric Flatfoot: Article suggesting Only Prescribing Orthotic Devices When There Is Pain
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We have all read these articles. At least this one gives credit to orthotic devices helping children with pain related pronation. Having treated my share of children with flat feet, and working alongside the podo-pediatric guru Dr. Ronald Valmassy, I have some thoughts to reflect on. First, I need to ask you this question. What are two of the most important parameters of healthy feet?
There are many answers, but the two I see the most are lack of pain and full function. It is the function of children that never gets studied enough. Children with pain related to their flat feet do come in, but most just adapt to this genetic weakness. The worse their feet are, the more they adapt. At the severe end of this spectrum, some have both pain in day to day activities and would not dare to run or play a weight bearing sport. But most of these children are not at the end of the spectrum, but somewhere between normal and severe pronation. So, they adapt their world to not have pain, and their parents do not look at their feet as a possible source of why Johnny or Jane are not the star athlete.
So, my suggestion if this reasoning is not logical to you. When you see parents with flat feet, ask them about the children that they brought into this world and must take care of. Do any of their offspring have their feet? When they bring these children in, ask both about pain and activity. Do not stop questioning when the child says that they can do anything they want to. Remember, most children will minimize their symptoms because they really want out of your office. Plus, they may have buried mentally any symptoms they had walking or running a long time ago. Find out what they are doing every week for activities that require their feet. Does this amount of activity seem like a normal amount? I bet you will find many children not participating much in normal activities due to their feet.
One of the main reasons I see children from a pain standpoint not from pronated feet is Sever’s Disease. I see this pain syndrome in very active children which do not have to have anything biomechanically wrong with their feet. This is an example of a pediatric foot problem typically not related to pes planus. But, I would say that on average when children begin an exercise program and they are on the pronation spectrum, they have more of a chance to develop pain.
Here is the KevinRoot Medical device for pediatric flat feet that works very well.
