Children with flat feet and in-toeing gait, may need assessment by a physiotherapist who can make recommendations regarding management. Heat moulding medical orthotics are an alternative for custom made orthotics, and can be fitted by a physiotherapist. Children always need to be assessed for suitability. For some children, the combination of exercises and orthotics, helps to minimise orthopaedic problems.
Signs for parents to look out for are: shoes wearing out quickly or unevenly;
flat feet that are not correcting, or worsening after the age of 8 (but problems can occur earlier); movement problems in one or both legs that might be apparent when running or walking; pain in the heels, legs or back; tiredness when walking, persistent walking on the toes. If you notice these signs, see a physiotherapist.
Very often exercises are necessary to strengthen or stretch and stabilise the legs, which complements the function of the orthotics. Early assessment and intervention or advice is considered as best practise.
Children with more severe problems with the feet may need to see both a physiotherapist (for specialist exercises based on assessment), and podiatrist for custom made orthotics.