I am frequently asked by worried parents about their childrens’ feet. Are they normal? Are they flat footed? Should they have orthotics?

While sometimes in specific cases, an orthotic might be warranted, more frequently the children in question are demonstrating quite a normal response to long periods of sitting, constant use of footwear, very little barefoot time, and lack of sensory connection to the feet.

The most common presentation is the overly rolled in foot, described as the over pronating or more inaccurately, a “flat” foot. You might see that as your child takes weight through their foot, the ankle seems to collapse a little on the inside, flattening the arch, and it may be accompanied by the knee moving inwards as well.

When you see this, there’s no need to panic! It’s time for some positive training games.

Firstly, let’s get some foot muscles working. With the child sitting, place a towel under their feet. They are going to keep their foot in place and use their toes to grab onto the towel. By using the toes to reach and pull, they will gradually scrunch the towel up under their foot. It’s a good workout!

Then we need to connect the foot to the ankle and knee. Start with your child sitting, and ask them where the pressure is under their foot. Ask them to put their hands on their knees so that they don’t move, and get them to experiment with moving the pressure slowly between the inside and the outside of the foot, making sure that the
y feel every bit of skin under the foot on the way from one side to the other. Depending upon the age of your child, you can play the marshmallow game – either imagining a marshmallow under the arch, (or using a real one), ask them to alternate between gently squashing the marshmallow under their arch, and then slowly letting the pressure off it to let it expand again.

Finally, put it all together with a balance challenge. The child will stand on one leg with their knee and hip bent. They are going to practice “not squashing the marshmallow” under their arch as they play Simon Says with you. “Simon says… touch your nose; touch your left hand to your right shoulder; touch your knee” and so on. Let them wobble and recover, rather than “trying to stay still” which simply increases tension and makes it harder to balance.

The biggest thing is to allow your child to connect with their feet again. Give them the opportunity to go barefoot when they can. Don’t be afraid of rough ground – those feet will be so
much better for learning to adapt to an uneven surface. Use simple cues like the marshmallow to encourage better lower limb mechanics – they are easy and fun but very effective. Walk on the outsides of the feet, on tip toes and on heels, pick up objects with the toes while keeping balance on the other foot, and learn to maintain balance with the eyes shut to strengthen the sensory connection between the foot and the brain.

So focus positively on developing strong, healthy feet with your child. Our feet are marvelously engineered, not fatally flawed. They don’t automatically come with the need to be protected with external support. They do however need lots of early opportunity to develop, so make foot games a regular part of life. One of the best physical gifts you can give your child is a foot to stand on.

Written originally for www.everactiv.com