The Foot Problems Of


Many foot conditions that are seen in childhood develop into larger mechanical and structural problems in the adult, so it is very important that pediatric foot problems be treated as early as possible. 

We'll discuss some of the most common pediatric problems here--being pigeon toed, being flat footed and toe-walking. 

Toeing In

When an intoed position develops from a problem within the foot (it may also be caused from a misalignment in the hip), it is usually because of a condition known as  Metatarsus Adductus.  (which literally translates to the metatarsal bones position being drawn in towards the midline of the body (an  "adducted" position).  

The cause of this condition is from an abnormal position within the womb.  As the womb can be a tight place, babies positioned with their feet malpositioned may develop misaligned metatarsal bones in an "intoed" orientation.      


   Toeing In

(Image Courtesy of La Trobe University, Australia)

While more severe forms of this condition like the one to the left may be recognized immediately after birth, it often isn't recognized until the child starts walking.  

Excessive tripping or apparent clumsiness are often the first signs the parents notice. 


If you begin early enough, it is possible that toeing in may be corrected with stretching exercises.  A podiatrist can teach the parents some simple exercises that can help improve this condition. 








It is often necessary, however, to use casts to realign the baby's feet into a normal alignment.  The casts typically applied in multiple sessions, to gradually reposition the feet.  This treatment works best in the first year of a baby's life, when the bones are not fully developed and before the baby begins to walk.  

Special braces and orthoses (orthotics) may be of use in later years. 

Flat Feet

You can access our web page devoted to flat feet if you wish, but there are some considerations of flat feet that are unique to pediatrics, and we'll mention them here.  

The first thing you should know is that all babies appear flat-footed in the first months of life.  This is partly because there is a fair bit of fat on the bottom of the pediatric foot that masks what arch there is, and partly because the arch of the foot evolves over time.  The important lesson to learn here is that most young children with flat feet may not have to be corrected at all.  It's important to have your child assessed to know whether the apparent flat-footedness is pathological and warrants treatment. 

To the parents' eyes, the most common clue to a flat foot that may require treatment is (in the earliest years) an excessive crankiness during bouts of walking, accompanied by frequent demands to be picked up or placed in a stroller.  Later, when the child learns to verbalize his feelings better, there will be complaints of being excessively tired with activity.  Often the child is not the fastest in the class when running any distance.

When presenting problems, many types of flat-footedness may be controlled and made more comfortable through orthoses, (or orthotics).  (Visit our web page on orthoses by following the link.) Suffice it to say that orthoses are devices used in the shoes to attempt to control the collapse of the foot in stance. 

In some cases orthoses may not be successful in treating flat-footedness.  Luckily, there have been recent advances in foot surgery to address this condition when conservative treatment fails. 

The lesson to learn here is that if you suspect a foot problem, have a podiatrist examine your child.  You may spare your child a great deal of hardship in adulthood. 

Toe Walking

Toe walking is called "Equinus", meaning the condition appears like a horse's foot. (Visit our page devoted to Equinus by following the link.)  

Forelimb conformation: lateral A horse's hoof is really a specialized way for it to stand on its toes.  In the illustration to the left you see the horse's leg.  To the right is a close-up, cross-sectional picture of a horse's hoof.  Pictured are the three toe bones, (phalanges).  

As you can see, the horse really does stand on its toes. 

Acute founder

There may be many reasons why a child may toe-walk. 
A tight heel cord.  This is the most common cause of this complaint.
Delay in the development of the spinothalamic tract in the brain.  If this is the cause, it usually disappears by age 8. 
Any one of several neurological disorders. 

Treatment may include shoe therapy, orthoses, casting and surgical intervention. 

Growth Plate Disorders

This problem is common in children, and is discussed more thoroughly on a separate web page devoted to Growth Plate Disorders.  

Ingrown Nails

Ingrown nails are particularly common with young patients, particularly during the teen years.  We cover this topic on its own web page.  Just click on the words Ingrown Nails.


Kids get warts more than anyone else.  This topic is covered in detail on its own web page.  Just click on the word Warts.



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The Achilles Foot Health Centre
S. A. Schumacher, D.P.M., F.A.C.F.A.S., F.A.C.F.A.O.M.  
Dr. S. A. Schumacher, Podiatric Corporation  

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