What you can expect from us

What is Normal for Children?

Development of children’s feet

• At 6 months of age the foot is still mostly cartilage
• The final bone doesn’t start to form cartilage until 3 years
• By 18 years, most bones are fully matured
• Most toddlers are flat-footed when they first start walking, because the bones, muscles and ligaments of their feet are under-developed.

Growing feet

• A child’s foot will double in size by the age of 1
• The foot is approximately half their adult length by 18 months of age
• Between the ages of 5 and 12 years, the growth is approximately 9mm per year
• An adult foot size is usually between 12 and 14 years of age
• Socks and shoe sizes need to be changed frequently to accommodate for rapidly growing feet
• Always measure and fit a shoe with the child standing as the foot spreads on weight-bearing.

Walking

Walking usually begins between the ages of 10-18 months of age, although each child is unique in their developmental milestones.

The usual progression in their milestones is lying and rolling, sitting, crawling, standing, cruising, walking, running, and then jumping and hopping. However, it is not always in this order.

When your child starts walking, it is important for them to go barefoot or to just wear socks as much as possible, ensuring it is a safe area to do so. This will improve the sensation in their feet, encourage grasping action of their toes, and promote normal foot growth.

You may notice variations in the walking styles of toddlers. In many cases, children walk with their feet pointed inwards (in-toeing) or outward (out-toeing), or others walk on their toes (toe-walking). Most children grow out of these styles of walking by 2 years old, however it is important parents bring their children in for a podiatry assessment to ensure there are no underlying causes of these walking styles. It is best to pick up any problems as early as possible.

Common Conditions

Below you will see some common conditions we treat.

This is not an exhaustive list of the many conditions or presentations we see walk into our clinic. If you are at all concerned about your child, or would like to know if our podiatrists can help, please don’t hesitate to contact us directly.

Skin & Nails

It is important that children’s nails are cut straight across.

Common skin and nail conditions include:

• Ingrown toenails
• Athlete’s foot (tinea pedis)
• Warts (verruca/plantar warts)
• Fungal infections or discoloured nails

Walking Abnormalities

A common concern expressed by parents in our clinic is the way their child is walking. Some alignment issues may be as a result of the positioning of the baby in utero, and may not be until the children is 4 years old that we can see complete resolution of the alignment. Those that become problematic due to simple alignments issues can often be treated simply and conservatively with great results. Some of these conditions include:

• Toe walking
• In-toeing (“pigeon toed”)
• Out-toeing
• Flat feet

Delayed Development

Whether it is children who are a little behind in reaching their developmental milestone, or children affected by neurological and developmental disorders, podiatrists can often assist in may ways to improve the child’s walking, balance and motor skills. Some of the more common symptoms we might see include:

• Tripping
• Clumsiness
• Reduced coordination
• Reduced muscle tone

Bony Injuries & Presentations

Whilst many of out 28 foot bones start developing in utero, most do not finish maturing until we are 18 years old. While the bones of the lower limbs are undergoing development, they may be susceptible to certain trauma, commonly at sites where the tendon attaches onto the bone. The two most common we see in the clinic are:

• Sever’s disease (at the heel bone)
• Osgood-Schlatter’s disease (at the knee)

Abnormalities in the shape and appearance of the toes is far more common than most people think. Many children inherit toe-deformities from birth, whilst others may acquire developmental deformities that appear when the child begins to weight-bear. Some common toe troubles that we encounter include:

• Juvenile bunions
• Curly toes
• Overlapping toes
• Hammer toes/claw toes

Early intervention is the best.

If you have any concerns or questions about your child’s feet book in to see our paediatric podiatrists, located in Tuggerah, North Wyong and West Gosford on the Central Coast NSW.