By Dr Suhel Kotwal, MS
When you have a new born in the family, one of the many apprehensions of parents regarding normal growth is the development of deformities. As time passes, parents may notice that their child’s growth isn’t occurring normally. Many young children exhibit flat feet, toe walking, pigeon toes, bowlegs, and knock-knees in their first few years of life.
Some of these conditions correct themselves without treatment as the child grows. Others that persist or become more severe may be linked to underlying problems. Many bone conditions, like dimples or cleft chins, are just normal variations of human anatomy that don’t require treatment.
Flat feet
Many babies are born with flat feet and develop arches in their feet as they grow. But in some kids, the arch never fully develops. As a result, the ankles appear to turn inward because of the way the feet are planted.
Flat feet usually do not represent an abnormality of any kind, and doctors only consider treatment if it becomes painful. They also don’t recommend any special footwear, such as high-top shoes, because these do not affect arch development.
Parents with flat-footed kids sometimes say their children are clumsier than others, but doctors say that flat feet aren’t a cause of concern and shouldn’t interfere with the ability to play sports. Sometimes doctors will recommend inserting arch supports into shoes to reduce foot pain.
Toe walking
Toe walking is common among toddlers as they learn to walk, especially during the second year of life.
Intermittent toe walking should not be a cause of concern. But kids who walk on their toes almost exclusively and continue to do so after two years of age, should be evaluated by a doctor. Persistent toe walking in older kids or toe walking only on one leg might be linked to other conditions, such as cerebral palsy or other nervous system problems.
Persistent toe walking in otherwise healthy children occasionally requires treatment, such as casting the foot and ankle for about 6 weeks to help stretch the calf muscles.
In-toeing (Pigeon toes)
In-toeing, or walking pigeon-toed (with inwardly turned feet), is another normal variation in the way the legs and feet line up. Babies may have a natural turning in of the legs at about 8 to 15 months of age, when they begin standing. The medical name for this condition is femoral anteversion.
Treatment for pigeon-toed feet is almost never required. Special shoes and braces commonly used in the past have never been shown to speed up the natural slow improvement of this condition. This, too, typically doesn’t interfere with walking, running or sports, and resolves on its own as kids grow into teens and develop better muscle control and coordination.
Bowlegs
Bowleggedness (medical name: genu varum) is an exaggerated outward bending of the legs from knees down. It is commonly seen in infants and, in many cases, it corrects itself as the child grows. Bowleggedness beyond the age of 2 or bowleggedness that only occurs in one leg but not the other can be the sign of a larger problem, such as rickets.
Rickets, a bone growth problem, usually caused by lack of vitamin D or calcium in the diet, causes severe bowing of the legs and can also cause muscle pain and enlargement of the spleen and liver.
Rickets is much less common today than in the past. Rickets and the resulting bowlegs are almost always corrected by adding vitamin D and calcium to the diet. Some types of rickets, however, are due to a genetic condition and may require more specialized treatment by an endocrinologist.
Knock knees
Most kids show a moderate tendency toward knock knees (medical name: genu valgum) between the ages of 3 and 6, as the body goes through a natural alignment shift. Treatment is almost never required as the legs typically straighten out on their own. Severe knock knees or knock knees that are more pronounced on one side sometimes require treatment.
In conclusion, no childhood deformity should be neglected, yet on the other hand a panic situation and frantic medical opinions are uncalled for too. A paediatric physician in conjunction with an orthopaedic surgeon can provide the best advice. Even in the worst case scenarios, a child growing up with a deformity can be surgically cured if the need arises.
