September 2010 – Patient Sympathy

August 2010 – Back to School Shoewear

July 2010 – Womens Shoewear

June 2010 – Summer Foot Care

May 2010 – Skin

April 2010 – Ingrown Toenails

March 2010 – Barefoot Running

February 2010 – Pediatric Flatfoot

January 2010 – Being a Compliant Patient

December 2009 – Raynaud’s Disease

November 2009 – NA

October 2009 – Shin Splints

September 2009 – Dealing with Corns and Callouses

August 2009 – Relieving Painful Gout

July 2009 – Caring for Plantar Warts

June 2009 – Bunions

May 2009 – Children's Heel Pain

March/April 2009 – Heel Pain

February 2009 – Shoe Fitting

January 2009 – Nail Fungus

December 2008 – Neuroma

November 2008 – Diabetic Foot Care


February 2010 - Foot Issues by James J. DeLorenzo, DPM

Published in - Healthy Lifestyles

Recently, I attended a four day conference in NYC listening to lecturers from around the country on a variety of topics from Diabetes to surgery to nail fungus,, and everything in between. Two of the more interesting lectures to me, covered a topic that I have a great deal of interest in. The lectures were on Podo-Pediatrics. This is a branch of podiatry which focuses on any and all ailments of children’s feet.

This is not limited to plantar warts or ingrown nails. This includes a wide variety of pedal issues such as flat feet, knock-knees, bow-legs, club foot, in-toe (pigeon toed) and out-toe (duck) gaits, as well as other concerns.

One of the issues discussed is called, the Flexible Flatfoot in children. The lecture centered on whether or not to treat this condition, or wait to see if nature corrects it all on its own. Although the debate continues to divide certain healthcare providers, I am of the belief that it is better to address the problem than not do anything at all.

So, what is a flexible flat foot? A flexible flat foot is one that appears to have an arch when there is no weight placed on the foot, such as when it is hanging off the couch. When weight is placed on the foot while standing or walking, there doesn’t seem to be any space between the foot and the floor in the area of the arch. When this occurs, the foot rolls down and in (pronates) because the arch is collapsing. The opposite is true in supination-the foot rolls up and out.

In and of themselves, pronation and supination are not a bad thing and are actually necessary for normal motions about the foot and ankle. It becomes a problem when there is way too much motion. Therein lies the problem, too much motion.

No one has an arch per, se when they are born. The arch develops over time as you’re growing and developing. A good rule of thumb seems to be to look at your parents’ feet. You are destined to have one or the other’s foot type, or at least a combination thereof. So, if you do have issues with your feet or any other characteristics you don’t care for, blame you parents. Or, their parents. What’s an extra session with the therapist?

Having a high arch or a low arch is not necessarily a good or a bad thing. It is what it is. Each type has its own advantages and disadvantages. Neither type is generally painful but it appears that the flat-footed individual has a more troubled existence owing to the increased motion, as mentioned.

Children with a flexible flat foot condition may or may not complain of any problems with their feet, necessarily. It can be that they trip and fall while running or even while casually walking along. It could be that after short periods of time walking they complain of tired legs, knees or feet. It could also be that a certain something isn’t just right when you watch them while they’re walking or playing and are oblivious to everything else around them.

Now don’t be alarmed, some kids do ‘outgrow’ it to a varying degree and never have any issues, and of course, some do not. Some studies have shown that children who have flat feet can be more prone to develop problems into adulthood. These can include bunion deformities, shin splints, knee, hip and back problems, as well as others.

Since this is a biomechanical or structural issue, it should be addressed during the early stages of walking and monitored over months or years. This is especially true of active children involved in a running sport such as soccer, lacrosse, and baseball to name a few.

There are a number of conservative, non-surgical treatments available which will allow any child with a flexible flat foot a helping hand while growing and developing into adulthood. An evaluation of the structure of the lower extremities including joints, muscles and bones and gait, as well as any other concerns, are addressed.

These consist primarily of some type of orthotic which is a customized or pre-fabricated shoe insert that will aid in supporting the arch, and eliminating or decreasing the amount of motion in certain joints. There is no “one size fits all” insert because there are no two people alike in their specific needs.

If you know of an infant, child or toddler that has flat feet, curved feet, walks in-toed, out-toed or trips frequently, please have them evaluated. It may help them in the long run.