Author: Dr. Marc Mitnick
Reviewed by: Medical Review Board

CHILDRENS ORTHOTIC

Most toddlers start to walk at around 12 months of age, some sooner, some later. All children once walking will exhibit two common attributes. They will all be flat footed and they will all walk with an abductory gait (toes pointed outward), in an effort to better balance themselves.

The flat feet that toddlers and small children exhibit is usually due to lack of formation of an arch at such a young age and in some cases from children that have very "chubby" feet which kind of hide the arch and make the foot appear flatter than it actually is.

IS FLAT FEET A PROBLEM?

As time passes many children will start to walk in a normal gait with their toes pointed forward and some sort of arch will be present. Some will not. Some of these young children will remain excessively flat footed. Is this a cause for concern? Perhaps. Children over 2 years of age that still seem to be excessively flat footed should be examined by a podiatrist to determine if the degree of pronation (flattened arch) is normal for that age range or is it a sign of a developmental abnormality.

If older siblings or perhaps one or both parents are excessively pronated then there is a very good chance the young child will also end up being excessively pronated. Excessive pronation is the underlying source to many of the foot, ankle and leg problems that are discussed on this web site. As it relates to children, excessive pronation may be the source of night cramps, or children who easily fatigue when having to do any fair amount of walking, over even the onset of juvenile bunions in teenagers.

If your pediatrician, podiatrist or orthopedist determines that your child is excessively flat foot or even moderately flat foot with a positive family history, then the way we treat this condition is through the use of orthotics. The idea here is by supporting the unformed arch in a child the foot is more properly aligned and as the bones fuse and the child develops hopefully an arch will be formed.

HOW DO ORTHOTICS WORK?

Orthotics for children are made out of very hard acrylic because it is the goal of the orthotics to cause the maximum amount of correction in the arch area as well as the alignment of the heel to the lower leg. By wearing an orthotic the child's foot is properly aligned to the lower leg and allows for maximum function of the foot in walking and running plus it helps the foot develop in a more acceptable fashion.

Although you cannot visualize it in the pictures orhotics for small and growing children have what is called a deep seated heel cup which forces the heel into a straighter alignment. I mention this because it is important to know that orthotics for children are not just arch supports in a smaller size.

Prescription orthotics are expensive generally running in the price range of $300-$600 or higher. Some insurance companies will cover them, many will not. The cost factor is further exacerbated by the fact because children are rapidly growing, they will out grow their orthotics in a very short period of time and will have to be replaced.

So, if your doctor has recommended you consider orthotics for your child or your child is experiencing night cramps or seems to fatigue easily while walking a fair amount or when playing sports that require a lot of running then you should consider this off the shelf type of child's orthotic.

The juvenile orthotics that I offer are manufactured by KLM labs, a nationally recognized orthotics lab. They are made in the same professional manner as the SuperStep orthotics that I offer on this site for adults. They are not prescription orthotics but they are made out of the same prescription grade materials. They are sold by shoe size not foot structure but offer a great alternative in those children where prescription orthotics are not an option or in children where there is a family history of excessively flat feet.

For children in the 1-4 age range I offer Kiddythotics which are available in children's shoe sizes 1-10.







For children in the 4-7 age range I offer Juniors which are available in adult sizes 1-6.