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How Do I know If My Child Needs Orthotics?


After almost 30 years of clinical practice as a Registered Chiropodist, this question still remains one of the most frequently asked. My standard response to reassure anxious and concerned parents who bring their child in to the clinic for an evaluation that most young kids will indeed have the appearance of having “flat feet” because the average foot does not begin to realistically demonstrate what its future shape will be until age 4-6.  That being said, parents only have a small window of opportunity to effect significant change on their child’s foot structure and gait mechanics, and if feet still look flat by age 6 or 7, it probably will not fix itself and will require intervention.

In most cases, these concerns resolve without the need for any intervention.   In the natural course of growth and development, the child’s bone and muscle will create a more “normal” foot structure and function.  However, I always caution the importance of keeping a close eye on the child and encourage the parent to return once a year for a re-evaluation.  These annual reviews allow us to monitor development and intervene if and when necessary.   

The goal of orthotic treatment is to gently reposition the foot in a more optimized biomechanical position.  Improved foot structure gives rise to improved foot function and symptoms usually will improve or disappear.  In most cases, we recommend that the toddler foot not be assisted with an orthotic so as to not interfere with normal development.  However, if certain symptoms persist or intensify, the recommendation may be that we intervene at an earlier than usual stage to minimize any further developmental damage and in the hopes of correcting a mechanical condition before it takes a firm “foothold” so to speak.

The decision on whether a child would benefit from orthotics is based on a collection of signs, symptoms and features that can be easily screened for when the Chiropodist/Podiatrist has the opportunity to evaluate the child over time.  

Orthotics are Required if a Child Manifests a Combination of Some of the Below Factors

  • Walking with either an “in-toeing” gait (pidgeon toe) or “out-toeing” gait (penguin toe)
  • Has no visible arch in their instep
  • Toe walking or heel walking
  • Stumbling, clumsy and tripping over their own feet
  • Found to be excessively scuffing the toes of their shoes
  • Excessively wearing out the inside or outside heel area of their shoes
  • Wanting to be picked up and carried because they tire easily
  • Complaining of pain in their feet, legs, knees or even limping
  • Avoids physical activity like running, jumping or playing because of pain/fatigue

Early orthotic intervention is sometimes indicated if a child is predisposed to structural foot problems due to familial history, or developmental concerns that cause poor muscle tone, tight/weak muscles and ligaments.  “Growing pains” are often a sign of muscular imbalance and a brief course of physiotherapy may be required.

While some children may benefit from orthotics, we also will frequently recommend other valuable treatment options like over the counter devices, properly fitted supportive footwear, and physical therapy aimed at strengthening or stretching muscle groups.  These therapeutic exercises are taught to the parent so that treatment can take place on a daily basis between visits to the Chiropodist.  

Parents need to be reassured that their child is developing normally and regular visits to the Chiropodist will allow a trained and experienced health professional to objectively assess the situation and recommend whether when and if intervention is required.

At CanadaPhysio, we put concerned parents at ease about their children’s feet.  Our multi-disciplinary clinic professionals can provide education, evaluation, exercise therapy, footwear and orthotic devices for infants, toddlers, children and teenagers.  

Don’t let foot pain prevent you from participating in and enjoying life to the fullest. Treatment is readily available at any conveniently locations to serve your needs across Ontario, in Toronto, Scarborough, Whitby, Mississauga and London, our trained professionals can help you get back on track.

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