Children’s feet: Simple tests for problems

Flat feet (sometimes called ‘banana foot’):

  • The ‘arch’ of the foot is not an ‘arch’ but a bulge on the inside mid-section of the foot.
  • The foot appears to have an arch when not weight bearing, but no arch when weight bearing
  • When the child walks, the toes 2,3,4,5 claw at the ground on push-off, and the joint in the big toes curls upwards
  • The heel tips inwards, and may look bulbous.
Problem Flat Feet
Problem Flat Feet in infants

Postural Development Problems: Some problems are listed below:

  • Unusual crawling style:
    • commando crawl (lying on the stomach)
    • Crab crawl (one foot tucked under the bottom)
    • Knee crawling (the child ‘walk’ on their knees
    • Bottom shuffle
    • Bear crawl (the knees are not on the ground
  • The child is 8 months old and not crawling
  • The child is 15 months old and not walking
  • Falls over nothing or is clumsy
  • If over 2.5 years and not walking with the feet pointing straight ahead
  • If over 3.5 years and cannot stand on one leg or cannot hop 5 times on either leg
  • If over 4.5 years and cannot turn the feet in and out without the hands turning in or out
  • If over 7 years and cannot stand on 1 leg with the eyes closed for 10 seconds
  • Tires easily when shopping or going for walks
  • If you or someone else thinks your child is ‘lazy’
  • The child can sit in the ‘w’ position
  • When at rest and seated over the edge of a chair,  the feet or legs are turned in or out, or point straight down.
  • The sleeping position alignment of the feet and legs replicates the walking alignment problem
  • Does not like wearing shoes
  • Walks pigeon toed, on tip toes, with feet turned out
  • Has tight hamstrings:
    • Have the child lay down on the back, legs out straight.
    • Then bend one leg at the knee, so that the thigh is vertical
    • Then while keeping the thigh vertical, very slowly and gently raise the lower leg until there is resistance
    • DO NOT FORCE the leg any higher than this
    • If the lower leg does not easily reach vertical or near vertical, the child has tight hamstrings and should be assessed.

In-toeing/ Pigeon Toes/ Metatarsus Adductus:

  • To determine whether your child has metatarsus adductus, place a biro or ruler along the outside border of the foot held at the heel. If the front end of the foot is turned inwards metatarsus adductus is present
Metatarsus Adductus
Metatarsus Adductus
  • For general in-toeing/ Pigeon toes, check alignment of the feet and legs when your child is asleep. In-toeing can be due to problems in the hips, lower leg, and/ or feet. It is important that the location of the problem is identified.
Resting alignment of in-toer
Resting alignment of in-toer