Children's Orthotics
Concerned about how your child’s feet look? Think they might need orthotics?
Have flat feet yourself and feeling worried your child might too?
Foot posture issues and gait abnormalities are common in growing children. In most cases, the problem clears up itself as the child gets older. Still, if you are worried you can always pop in for a consultation with our podiatrists about your child’s foot posture and gait. There are lots of simple non-invasive solutions that can help with these issues.
Most cases only require footwear advice, posture exercises, reassurance, and time to grow. However, there are times when orthotics or other forms of treatment are indicated. At the Foot Hub, our podiatrists do a full evaluation to identify potential causes of your child’s posture or gait issues. Whether your child has flat feet, in-toeing, or another gait issue, we will recommend the best possible treatment option for their unique needs. This includes minimising interference with their natural gait — we only recommend orthotics when the child truly needs them.
Read on to learn more about the different foot posture or gait issues your child might have, the potential underlying causes behind them, and all the different treatment solutions available.
PODIATRIST ASSESSMENT
Before any orthotic therapy should be considered, a thorough assessment by a Podiatrist is critical. Podiatrists take into factor things like:
- Child's age
- Family history
- Activity level
- Trauma
- Medical history
- Symptoms
- Gait
A thorough history and assessment by someone with clinical experience can accurately diagnose and recommend appropriate treatment, as well as determine if orthotic therapy is required.
Parents do need to remember that most conditions such as flat feet and in-toeing do go away as children grow. Monitoring and conservative treatment could be all they need.
Three conditions in our Sydney clinic that we recommend orthotic therapy for are:
1. FLAT FEET IN CHILDREN
Children’s flat feet is a condition that is characterized by a low, longitudinal medial arch and everted calcaneus. There are two types of flat feet in children:
Podiatrists tend to focus on flexible flat feet as rigid flat feet do not respond well to orthotic therapy.
When it comes to children’s flat feet, parents and podiatrists should always be careful in diagnosis to make sure there are no other underlying conditions responsible for it. Potential underlying conditions might include:
- Ligamentous laxity of hypertonia.
- Lower or upper neuron lesions such as cerebral palsy, trauma, genetic errors, Down Syndrome.
- Congenital vertical talus, tarsal coalition, skew foot cause Rigid flat feet
Most of these conditions are non-responsive to orthotic therapy.
How to treat flat feet in children
Based on current evidence and clinical guidelines the following children would benefit from orthotic therapy:
- Children with a flexible flat foot with symptoms.
- Children with a flexible flatfoot who are obese, hypermobile, or with systemic or genetic abnormalities with or without symptoms.
Not every child with flat feet requires orthotics. Some only need monitoring and conservative treatment. Most children’s feet at the start of walking are flat, and as they grow their arches develop. However not every child’s feet will develop an arch. In fact, 26% of adults are flat footed.
goal of orthotics
Orthotics help reduce pain and improve function and structure in children with flat feet without interfering with their development. By using specific features in orthotic design, children’s orthotics stabilise and align bones and soft tissue in the feet and reduce any excess pressure on the feet caused by flat feet.
2. IN-TOEING
In-toeing is where the feet turn inwards when walking instead of being straight. It’s a common condition seen in children. Many children in-toe (1 in 10) as it’s a normal part of development and will resolve over time.
In-toeing can be caused by the following:
assessment
Most cases of in-toeing are developmental however it’s important to have a thorough assessment by a podiatrist to rule out any underlying conditions.
Some underlying conditions that can cause intoeing include:
- Cerebral Palsy
- Hip dysplasia
- Achondroplasia
- Clubfoot
Treatment for intoeing
Intoeing should reduce with age. If intoeing doesn’t reduce or increases with age, an assessment by one of our podiatrists can be helpful. We also recommend treatment if your child is repeatedly tripping and falling or if the condition is painful (in rare cases).
Treatment can include the following:
- Monitoring
- Changing sitting or sleeping positions
- Exercises
- Footwear changes
- Serial casting
- A specialised children’s orthotics called a gait plate
gait plates
Gait plates are specialised children’s orthotics that limits in-toeing and provides stability for the feet which helps reduce tripping or falling.
3. SEVER'S DISEASE (CALCANEAL APOPHYSITIS)
Calcaneal Apophysitis, commonly referred to as Sever’s Disease, is a common cause of heel pain in children between the age of 8 and 12. It is inflammation of the growth plate in the heel bone and can be exacerbated by repetitive stress or from conditions that cause increased tension or traction on the Achilles tendon, such as tight calf muscles and flat feet. This condition has been found to be more common in children who are taller and heavier.
Signs and symptoms include:
- Heel pain during or after exercise especially running
- Foot pain in the morning
- Limping when walking
- Tiptoeing to take pressure of the heel
Treatment of calcaneal apophysitis
Calcaneal apophysitis is a self-limiting condition that goes away on its own and treatment involves managing pain and reducing pressure on the heel bone.
Treatment can include:
- Icing
- Activity modification
- Load Management
- Heel lifts made from EVA material
- Children’s Orthotics
- Time
Children’s orthotics for calcaneal apophysitis
Orthotics can help treat calcaneal apophysitis by reducing pressure and tension on the heel bone and reduces pronation caused by flat feet which can also add stress on the heel bone. Designed with inbuilt heel lift from EVA and sweet spot to cushion the heel bone, this can help reduce symptoms of this condition.
We know that as a parent, it can be worrying when you have concerns about your child’s health. If you would like to discuss any concerns about your child’s feet from an experienced, friendly podiatrist, book an appointment with our children’s podiatrist in Sydney today.
PREMADE ORTHOTICS VS CUSTOM ORTHOTICS
What is the difference and are custom children’s orthotics worth it?
Children’s premade orthotics can be used to treat the above mentioned conditions. They are a cost-effective solution and can be a good option for growing children. Many research studies have shown that premade orthotics have the same outcomes as custom orthotics.
Custom orthotics in children are more expensive and for a growing child this may not be a good long-term solution. Custom orthotics are made from a 3D impression of your child’s foot so they would have a better fit compared to premade orthotics which are made to fit “an average’s child foot.” They can also be more comfortable due to choice of materials and individual design features. At The Foot Hub we offer all orthotic options to our patients and endeavour to make sure that our orthotics fit. Should there be a concern, we make appropriate recommendations.
FOLLOW UP AND MONITORING
At The Foot Hub we review all our paediatric patients at 6 months or 12 monthly intervals to reassess and make sure orthotic therapy is still indicated. Symptoms can improve over time and so can clinical presentation. We encourage parents to continuously monitor children as their feet continue to develop.
COST OF CHILDREN'S ORTHOTICS
Are childrens orthotics covered by insurance?
Depending on your policy, if you are covered for podiatry and orthotic services you may be eligible for a rebate on your orthotics. Before making an appoinment, you’ll want to check to see how much your insurance will cover and what your out of pocket expenses will be.
Find below detailed item codes*:
Childrens Assessment
Children's Premade Orthotic
* Please be aware item codes vary across different health funds.
-
Biomechanical assessment $160
Visual gait analysis, footwear assessment, assessment for orthotic therapy (item codes: 004, 118)
-
3D scan of both feet $60
Scans of feet to make custom orthotics (item codes: 301, 301)
-
1 pair of custom orthotics $560
1 pair of custom orthotics and a short fitting appointment (item codes: 221, 221, 010)
-
2 pairs of custom orthotics $960
2 pairs of custom orthotics and a short fitting appointment (item codes: 221, 221, 221, 221, 010)
-
Follow up appointment $85
Orthotic review (item code: 012)
You can also take advantage of your private health insurance and our second pair discounts and get additional pairs each year for different shoes or activities, when it resets annually.
A COMMON STORY
Many people hesitant about buying orthotics tell a common story:
I used to wear orthotics as a child, and they were painful.
Here's our answer:
Orthotic theory, design and the materials used over the last few years have changed. With a proper assessment and new materials, comfort and fit has improved. With frequent reviews and monitoring the goal of therapy is to help, not cause pain. If any case were a child is experiencing pain from orthotics, we immediately stop the use of the device and find a better option that will comfortable and therapeutic.
FREQUENTLY ASKED QUESTIONS
No they may not need to wear them forever. At each review appointment the Podiatrist will reassess and make appropriate recommendations.
Custom orthotics are handmade and take some time to make due to different stages to the manufacture. Also, the materials used to make them are specialized and therefore costly. At The Foot Hub we try to make all our services affordable without compromising on quality.
Make sure to take advantage of your private health insurance and our offers like Afterpay.
Depending on stock availability premade orthotics can take up to 7 days to be fitted.
Depending on how often you wear them, and the materials used custom orthotics can last for more than 3 years.
It takes 2 weeks to get your orthotics to you. Should there be delays your Podiatrist will advise you at time of your appointment.
The Foot Hub uses a state-of-the-art orthotic laboratory in Queensland. All orthotics are hand made with high quality control and finishes to make sure that orthotics delivered to are patients are perfect.
Yes they do wear out over time due to use and activity. If the topcover of the orthotic is worn this can be easily replaced however if the shell of the orthotic is cracked or warped, a replacement orthotic would be indicated.
Orthotics can last for a long considerable amount of time. Depending on how often you wear them, and type of activity you should expect your orthotics to last over three years. Sometimes the top cover can wear out, this may need to be replaced before that. Always talk to your Podiatrist about what activity you would need your orthotics for so that suitable and durable materials can be chosen.
CARE INSTRUCTIONS
- To clean your insoles, wipe down with a damp cloth. Remove sand and dirt for your insoles with a damp cloth regularly to avoid cover separation.
- Avoid exposure to extreme heat or direct sunlight.
WEARING INSTRUCTIONS
- Begin by wearing orthotics for approximately 1-3 hours on the first day of issue.
- Increase the time by 1-2 hours every day until they can be worn all day.
- Parents should mointor children and look out for signs or rubbing or irritation
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