Many kids walk with an in-toe when they start to walk. This is due to an internal rotation of the lower leg bone (tibia). As a child grows, the tibia bone should start to unwind and straighten (This occurs while the growth plates are still open), thus making the knee and the ankle position the same. However due to environmental and other factors, these bones are not correcting themselves enough, thus leaving the tibia bone in an inward position, which in-turn causes the body to try other means of correcting the foot position. The body uses other muscles to correct the child's walking. This in turn gives rise to other complications like growing pains, strained muscles and over compensation issues.
Pediatric assessment needs to be conducted to determine the extent of the tibia torsion.
There are treatments available, which assist in re-aligning these bones. This can only be done when the child is still young, and the growth plates are still open. Treatment may vary from person to person. Biomechanical assessment is necessary to determine the method of treatment.
Knee pain is a vague statement and can refer to many problems of the knee. The most common being diffused pain around the patella (Known as Patella-Femoral pain syndrome) and knee arthritis.
Knee arthritis is characterised by a decrease in joint space. This can be a very painful and frustrating condition. Many problems of the knee can be related to the foot and the ankle, as the knee and hip are connected. Through an assessment, it is possible to determine certain aspects of the foot position in relation to knee osteoarthritis.
Patella-Femoral pain syndrome is nominally characterised by general, diffuse knee pains, which get worse during sporting activities and walking up/down stairs. It has a lot to do with mal-alignment of the patella and incorrect knee function.
Through an assessment, causes of these knee problems become clear. Causes may be due to the feet or muscle imbalances of the muscles working around the knee.
The foot and knee have a very close relationship, what the foot does will affect knee function. This is best treated by custom inserts which change the position of the foot. This will change the mechanics of the knee and thus, offload the pressure points of the knee and improve its range and quality of motion. Acupuncture also works well in reducing pain in the knee. An assessment is needed to determine the type of insert needed.
Bunions (hallux valgus) are often described as a bump on the side of the big toe. With a bunion, the big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion's "bump."
Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which continues to become increasingly prominent. Usually the symptoms of bunions appear at later stages, although some people never have symptoms.
Bunions are most often caused by an inherited faulty mechanical structure of the foot. So normally someone in the family may have them.
Symptoms:
Other conditions which may appear with bunions include calluses on the big toe, sores between the toes, ingrown toenail, and restricted motion of the toe.
Early treatments are aimed at easing the pain of bunions and stopping the bunions from getting worse, but they won't reverse the deformity itself. The Mechanics of the foot would need to be addressed and a suitable treatment plan put in place.
Patients who have diabetes or considered 'high risk' constantly need foot and nail care. This is because incorrect nail cutting can be the cause of ulcerations and infections. Yearly vascular, neurological and motor assessments are conducted on the feet. This is to determine the current health of the feet and to determine what problems the patient may encounter. Patients would normally be referred by their G.P on a Medicare Enhance Primary Care plan (EPC), in which gives patients 5 visits per year on Medicare. Patients need to speak to their doctor if they are eligible. If not, they can attend as a private patient.
