Dr. Tsatsos comments on Children & Overpronation

I had noticed years ago that my 10 year old’s feet were “flat” and very narrow.  I mentioned it to the pediatrician a while back and he said to watch it.  Recently suggested inserts in her shoes. She is extremely difficult to SHOE!  Nothing fits her feet.. She can’t put inserts in every shoe.  When she gets to be a teen, she’ll want to wear prettier shoes.  Do the inserts correct or just correct when wearing them?  Should she have surgery.   I know this issue will cause all kinds of pain in the future and I would like to help her avert all that if I can.

ANSWER: Generally speaking, it sounds like your child needs orthotics (also known as orthoses).
An orthotic is a custom prescription device that can only be made by a lab with a prescription from a podiatrist or other qualified physician. Forget the shoe store and other over the counter products.
Please worry more about function than fashion. If the orthotic is to help it needs to be worn in her daily activity shoes and needs to be able to address the problem. Usually you need 2 pair-to exchange & if missing-or for different shoes-you know how kids are.
“Flat feet” may not need to be treated–if the doctor deems it not to be a problem.
Although I take my daughter to the pediatrician-I would never ask her an orthopedic question—their training is not sufficient to recognize these problems.
Get a good diagnosis from a podiatrist or orthopedist who specializes in child orthopedics. If surgery is recommended-get a second opinion to confirm.
Hope this helps!
Dr George TsatsosDirector AnklenFootCenters.com

Fellow American College of Foot & Ankle Pediatrics

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