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In toing

Gait means the pattern of how your child walk. A Gait problem may be caused by different factors such as an injury, vision problems, orthopaedic or neurologic disorders.

The types of common Gait problems are In-toeing walking, Tiptoe walking, knock knees.

Most of the time, the Gait problem resolves on its own but sometimes not. If you have any concerns about the way your child walks, you should seek advice from a trained paediatric physiotherapist.

How can I help you?

I will help your child establish reasons behind types of Gait problem. If an issue is identified on assessment , a treatment may include:

Stretching or strenghtening exercises for any muscles umbalance

• Advice on motor skill acquisition if any delays

• Advice on shoe wear 

Foot deformation

Metatarsus adductus and varus is a common foot deformity noted at birth that causes the fore foot to turn inward. It is caused by the infant’s position inside the womb.

It is important to treat it after birth because it is one of the reasons why people develop “in-toeing” walk.

If the foot is very flexible and easy to straighten in the other direction, the problem will resolve in few days with muscular stimulation and a light strapping. The baby will be followed closely for a period of time.

If the foot is rigid, your baby will need mobilization and wear a splint or special shoes. 10 sessions are required.

Talipes calcaneus

Your baby’s foot is turned upwards towards the shin. This deformity is typically flexible and fully correctable if there is no neurological disorders, it is due to intrauterine mal-positioning which provokes an imbalance of foot muscles

This malposition can be resolved by mobilization, proper muscular stimulation and some feet require a splint.

Skew or serpentine foot

The foot appears to hook inward or has a “C” shaped appearance. It looks like a metatarsus adductus but it is not. It is rare deformity which if it has not treated provokes an irreversible deformity of the foot.

The “French Method” physiotherapy consists of mobilization, muscular stretching and stimulation. The foot is held in a support and a splint at the age of 2 to avoid the recurrence. The assembly is changed 2 times/week.  When the treatment is started earlier the result is best.

Congenital vertical talus or rocker bottom foot is characterized by a convex rounded bottom of the foot and the heel . It is a rare deformity, the cause is unknown.

If you early treat this deformity , you may have chance to obtain a best growth of the foot. Otherwise, the deformity will be worse with the growth.

The diagnostic is confirmed par X-ray and clinical examination

The rehabilitation consists in muscular stretching, immobilization of foot with a splint. Regular consultation with an orthopedist is essential to follow up the foot evolution. In most cases, the functional result is correct, the recurrence is rare and the physiotherapy reduces an invasive surgery.

Talipe equinovarus or club foot is a common congenital deformity whose the cause is unknown. It has diagnosed during the pregnancy and has to be treated from the birth. The affected foot appears to have been rotated internally at the ankle. Without treatment, the child will walk on their ankles. It involves one foot or both.

Nowadays, two physiotherapy treatments exists the “Ponsetti” or “French”method, I use the last one. The child's foot is gradually stretched to achieve the right position 3 to 5 times/ week at the beginning, being held in place with foot support and splint after stretching. The latest studies have shown that this functional treatment minimise the need for extensive surgery.

Your baby has to be followed regularly by a paediatric surgeon. It is a long process until the end of growth. The French method allows to treat and follow up your child, has a good result and can detect the recurrence or worsening during the growth.

Heel and Knee Pain

The osteochonditis is a family of disorders that affects the growth of bones in children and teenagers. It may cause pain and disability.

If the knee is painful, swelling and tenderness during sport or with direct contact, it may be an Osgood Schlatter’s disease. In other way, your child or teenager can suffer from a heel pain, especially if he practices sport. This non dangerous bone disorder is named calcaneal apophysitis or Sever’s disease

How can I help you?

Physiotherapy avoids growth plate damage which may make walking and running difficult. Your child will perform exercises to improve the flexibility and strengthen the surrounding musculature. Use of taping technique will improve knee motion and decrease pain with activities. The limitation of physical activities and physical load restriction help the healing.

Symptoms usually resolve in a few weeks to 2 months after therapy is initiated.

Kyphosis

Normal posture

The osteochonditis is a family of disorders that affects the growth of bones in children and adolescents. It may cause pain and disability. They affect different part of the body.

The Sheuermann disease affects the spine with a kyphosis exceeding 40/45° and can lead to a rounded upper back , sometimes called a hump back, in otherwise healthy adolescents.

The common treatment consists of bracing, casting and exercises for 1 to 2 years minimum and the earlier you start treatment, the better the results.

 

How can I help you?

The physiotherapy objectives will be to  strengthen back muscles, maintain flexibility of the back, correct lumbar lordosis, stretch legs and shoulders muscles and changing the patient’s breathing pattern in order to decrease the risk of spinal deformity curve progression.

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JOSS PHYSIO

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