The problem of toeing-out is often an over-rotation in the hip or leg.
Causes: Toeing-out is more likely to be inherited than from an abnormal position in the womb. This is also unlikely to be the result of abnormal sitting positions but some children may twist their leg bone (tibia) out too far by ‘w’ sitting.
Treatment: Exercises sometimes help with the problem if treatment begins at an early age.
Bow legs are normal at birth but should disappear by the time the child reaches two. If it does not disappear by the age of two then it may be permanent.
Causes: The bowed appearance may be caused by a curve in the leg bone ‘tibia’ or may involve the entire limb. This curve may cause the foot to roll or may place extra strain on the knee joint.
Treatment: The bow itself is not correctable but if pain occurs in the knees or feet orthoses may be useful to relieve any symptoms.
Knock-knees are normal in children aged from two to seven years. Some children may become knock kneed again around puberty.
If the problem has persisted from the age of seven, it may be permanent. Like bow legs this leg position may cause the foot to roll or may place strain on the knee joint.
Treatment: Sometimes using orthoses to straighten the foot can help straighten the leg but this may be a long-term treatment. If pain in the feet or knees occurs orthoses can be useful to relieve symptoms.
This is also called hypermobility, ligament laxity or low tone. There are several simple tests for this problem;
When testing at home care is needed, as most very young children will be flexible enough to show a positive result from these tests but be quite normal. If you are unsure of the result you should have your child examined by Dr. Shumate.
Treatment: Treatment for flexible joints is needed if the child is having difficulties with gross motor skills or complains of pain in the feet or legs. Orthoses are usually very effective for pain relief or improving stability in these children but there is no way of permanently ‘curing’ the looseness in the ligaments.
Many babies naturally appear flat-footed. Usually, this will disappear as the baby begins to stand and walk.
Children with flat feet, or low arches may not be able to keep up with other children because of the added strain on feet and legs.
Causes: There is no way of giving a child an arch if they have a true flat foot but may children who appear flat-footed have a normal arch but flatten it when they stand. This movement is called ‘pronation’ and may be cause a variety of painful symptoms, make the child tire easily or have problems with gross motor skills. If a child is pronating his/her feet orthotic devices may be useful to improve foot movement and relieve any painful symptoms.