I have been fortunate over the last 17 years to be able to create a great niche in my community for treating the feet and extremities. I have fitted hundreds of patients from ages 5 all the way up to the elderly with custom molded foot orthotics. These have helped not only the ankle, knee, hip and back pain they have consulted me for, but have stabilized their body so they stay in alignment longer.
I know you treat a multitude of children in your practice, just like I do. The opportunity often arises after we have been vetted by one or both parents and then the questions come flying out…. “Jimmy’s knees are hurting him”; ”Bobby’s back is bothering him”; “Annie’s sprained ankle has never felt normal again”
If you have heard me teach before, you know I am very big on the feet and arch stability. We have 3 arches: the medial longitudinal, the lateral longitudinal and the transverse. It is a clinical fact that fallen arches create problems from the ground up. The unstable feet can and will create stress on the joints and it is only a matter of time before pain follows.
If you stand up and roll your feet all the way inwards (dropping them to the floor), you can feel the stress that patients present with. The inner ankle, medial knee, lateral hip and pelvis and lower back all get stressed and you can feel this in yourself.
[quote_center]So how do you know when a child needs custom molded foot orthotics? [/quote_center]
The arches are fully formed by age 6-7. Once the child gets to this age, arch collapse, flattening or excessive foot pronation begins to happen. I have met many children who need orthotic support by this age, my son being a prime example. There are even some children who start showing signs by age 5. You need to use your clinical judgment of how early to intervene. I have absolutely prescribed Ultra Young Soles by Foot Levelers for a 5 year old.
When they stand in front of you, look for the foot flare in one or more of their feet (the feet turn outwards). You can often notice, even at the young ages, the falling in of the medial longitudinal arch. The achilles tendons may be bowing inward and their knees may look knock kneed. The over pronation pattern, like I described above, is a road map that we can use for children and adults alike.
Factors like genetics, sports, weight, height, shoes and activity levels will come in to play at any age. But the younger the patient, the more likely genetics is the prime factor. In fact, what works well for marketing your Chiropractic practice is being able to make the parent(s) understand that the child’s feet have been passed down by one or both of them. The parent(s) likely have arch issues that they will need you to address later. I get a lot of new patients this way as well.
When you suggest orthotic support for the child, most parents are on board and they understand why. Some express hesitation because of the cost. In my practice, I use Foot Levelers orthotics. You may use a different company. Foot Levelers makes an Ultra Young Sole orthotic which can be fitted for a child up to age 12. The cost is significantly less than it is for an adult orthotic, so parents appreciate this. Furthermore, Foot Levelers offers a 10% discount on all future orders of the Ultra Young Sole as the child grows up. This helps control costs for parents both financially and emotionally (kids are so expensive!)
What works so beautifully for anyone, whether they be a child or an adult, is to use the sports taping protocol I show for the 3 arches of the feet. This way, the parents and the child see how support will reduce and alleviate the pain while supporting their growing body and joints.
You will have tons of kids coming through your door. Take the time to make sure they have the proper arch support for all 3 arches. Children deserve the same support the adults have access to. You are helping them avoid a lifetime of problems by doing this.
Any questions? Let me know. Be well, my friends!
Dr. Kevin M. Wong is a Chiropractor who has been in private practice and Continuing Education Instructor for over 17 years. Dr. Kevin was a Valedictorian and Summa Cum Laude graduate of Palmer College of Chiropractic West in 1996. For the last 10 years, Dr. Kevin has been a Core Lecturer/Instructor for Foot Levelers where he presents his program on Spinal and extremity assessment and treatment. Aside from teaching over 50 hours per year, Dr. Kevin maintains his full time, family based, full spine and extremities practice in Orinda, CA.