Orthotics for children – are they a good Idea?

25 January 2011 - posted by Rebecca Gifford

The use of orthotics for children is a highly controversial subject that is rarely agreed upon by medical practitioners. The general consensus in New Zealand is that orthotics should only be used for children when symptoms related to foot and leg function are evident i.e. Osgood Schlatters (anterior knee pain). This is because children are still growing and developing and they may simply outgrow any concerns. However, often there are symptoms other than pain. Parents bring their children in to our clinic as they are concerned about their child excessively tripping or walking funny, these issues often resolve as the child ages however intervention from a podiatrist can help them successfully progress to this stage.

One of the most frequent concerns parents bring their children to see us with is flat feet. Flat feet are common in children, often resolving as they get older. Flat feet are not always symptomatic or painful but simply look troubling. If there is no pain associated with this condition just monitoring the child and their progress is recommended as they may never have issues relating to this and can simply outgrow this foot position.

If pain is occurring as a result of flat feet, then Junior Formthotics™ can definitely help to offload these areas. If the arch is low when the foot is off the ground Formthotics™ can provide support for the foot to encourage better function and posture. If the feet look flat when standing they are probably over pronating. Formthotics are designed to reduce pronation. They do this through their unique heat moulding process and arch contour design.

Pain associated with growth is also commonly diagnosed in children, Osgood Schlatters and Severs are probably the most common I see. Osgood Schlatters, or pain around the front of the knee, commonly occurs in children ages 10 – 15. It occurs when the tendon that runs from the patella (knee cap) to the tibial tuberosity (bump on the front of the shin bone just below the knee cap) pulls excessively. This causes the growth plate located at the tibial tuberosity to become aggravated and inflamed leading to pain and discomfort. Excessive foot pronation influences the knee to drop inward increasing the pull of the patella tendon on tibial tuberosity.

Severs is a similar condition to above as it too relates to excessive pulling on a growth plate. Again this usually occurs in children’s ages 10 – 15, as at the age of 15 most growth plates fuse so the injury becomes obsolete. Severs occurs when the Achilles tendon pulls too much at its insertion at the back of the heel causing inflammation of the calcaneal apophysis (growth plate). Again foot pronation is the most common influencer of this condition. Formthotics™ can help with Severs and Osgood Schlatters by correcting the over pronated foot position. Formthotics™ can be further modified by a podiatrist through heat moulding and other additions to the bottom of the insert. R.I.C.E, strapping, heel lifts, footwear, modify F.D.I of sports, stretching and pain medication can also help.

Training (frequent, intense, long), tight quadriceps, muscle imbalance/weakness, inappropriate foot wear and training surfaces can also influence knee pain.

If you are concerned about your child’s feet and think an orthotic may help or you would just like some more advice please contact your local podiatrist for an appointment.