Is My Child Walking Right?
Podopaediatrics is the evaluation and conservative management of congenital, developmental and traumatic conditions affecting the foot and lower limb of newborns to adolescents.
Normal development is characterized by the following milestones:
Around 10cm long at birth, your baby's feet will double in size in the first 12 months.
At 6 months the foot is still mostly cartilage. Full ossification doesn't take place until 18-25 years of age!
Most babies will start to crawl around 10 months and by 12 months they will start standing and walking with support.
Let them progress at their own pace rather than pushing them to walk too early - their little feet have to gain the strength to support their body weight.
At first they have jerky hip and knee motions.
By 15 months your infant will be walking unaided with a flat foot and full foot strike.
By 2 years they will be running with more flexibility at the knees and ankles with a period when both feet are off the ground, negotiating steps one at a time, jumping off a low step and kicking a ball forward. They will still appear flat footed.
By 21/2 years they can jump off a step with a 1 foot landing.
By 3 years they will have a near normal adult gait - that of heel strike to toe-off pattern, will be able to mount steps with alternate feet, jump off a step with a 2 foot landing and put on their own shoes. They will also be able to do some special tricks of walking on their tip toes as well as on their heels.
By 4 years they will be able to climb, walk downstairs with alternating feet, hop on 1 foot for about 5-8 consecutive hops, run on their toes and kick a ball in the air.
By 5 years your youngster will be skipping with alternate feet and be able to place 1 foot directly in front of the toe of the opposite foot walking forward along a straight line and generally be more rhythmical and efficient with assistive upper limb movements. Running by this stage will be characterized by the body leaning forward, arms swinging in a straight line with the elbows bent. They will by now have learnt all the skills of adult gait. >
My child has flat feet - What should I do about it?
Young children tend to have a fat pad in the arch giving the appearance of a flat foot.
It is usually not indicated to interfere earlier than about 6 or 7 years of age once their foot resembles that of an adult unless the youngster exhibits significant orthopedic or congenital deformities.
Expert diagnosis will alleviate your fears. If necessary proper care and treatment of the feet by your podiatrist beginning in childhood will prevent many of the mechanical and orthopedic problems seen in adults.
Other Deviations from Normal
Certain neurological conditions result in spastic gait for instance and orthopedic conditions such as congenital deformities, osteochondroses, fractures, torsional and positional deformities.
Manifestation of X and O legs is common in Indonesia as is flat feet.
In addition, many children walk with an excessively in-toe or out-toe gait. Although they may not be in pain, they are damaging their feet. If indicated, orthotics can be fabricated with a gait plate to help correct in-toeing or out toeing.
Another serious condition is talipes adductoequinovarus - club foot - which is rectified by serial casting and bracing. This method has significantly superior long term outcomes compared with that of surgical intervention.