Children’s movements frequently are seen as amusing, but they can be a cause of concern for parents. One of our patients came to the clinic because her three-year-old walked like the cowboy in old western movies—the one who had spent too much time on his horse.
‘What do you think, Doctor?’ said the mother. ‘Is he going to always walk like this? Should he have braces or something?’
It’s not unusual for children to have an awkward or unusual gait. While there are some diseases that affect the muscles, joints, tendons and bones, and these diseases can be detected in the walking pattern, children have a variety of ways of getting around while they’re young. These variations are usually not serious.
Bow legs are one of the most common phenomena we see in young children. Babies are born with bow legs. When they start to walk, the legs usually straighten.
The opposite syndrome is also common— knock knees. Both these conditions, bow legs and knock knees, should straighten out by the time the child is in second or third grade.
You should be concerned, on the other hand, if any of the following occur:
- bow legs that get worse after three years old
- bow legs or knock knees that appear suddenly
- the child begins to limp
- your child complains of pain when he or she is walking
- only one leg seems to be bowed or turned inward
- you notice swelling of the joints
Other common conditions are when the child is pigeon-toed or duck-footed. This is when the feet turn inward or outward while the child is walking. If the child consistently walks on tip-toes, you should call the clinic and bring him or her in for an evaluation. Our staff in Dallas, DeSoto or Sunnyvale can assess why the child is walking on tip-toes and whether this is a potential problem. Tip-toeing could be caused by tight muscles. There are other conditions that present as gait abnormalities, such as juvenile arthritis. A medical exam will determine whether the child needs treatment.
In general, parents should not be panicked if their child seems to have an abnormal gait, but they should observe any unusual patterns and have the child evaluated by a foot and ankle specialist.
Flat Feet and Good Shoes
While we might be concerned about flat feet in an adult, so-called fallen arches are not the same in children. Children are more loose-jointed and flexible, so the arch may be relaxed. Plus small children may have fat pads that hide the arches.
It is helpful to have the child fitted for good shoes. Shoes should fit snugly— but not too tightly— to avoid tripping or falling. Children’s footwear needs good traction, for the same reason. Ankle boots or shoes are preferred for toddlers just because they are more difficult to remove.
Children whose feet roll inward (pronate) may benefit from supports. If we see a problem when we examine your child, we may recommend an orthosis. Generally, these don’t need to be expensive, custom inserts; children outgrow shoes and supports in a very short time. It’s not a good idea, however, to use hand-me-downs. Each child’s foot is unique.
It’s important to remember that each child must figure out how to walk, and this is trial and error. Moreover, children learn differently, at different ages, and their styles can vary tremendously. While one child in the family might get off to a smooth start, another could be the future star of hilarious family movies.
Parents need not worry unless the child’s development seems very delayed, or he or she complains of pain. But in any case, a child should be seen by a foot and ankle doctor at some point before they start school, just to make sure they’re starting off on the right foot.