Thinking About Orthotics for Your Child? Try This First...

Filed under: Tweens, Teens, Development/Milestones: Babies

Dear Reggie,
My 11-year-old daughter Sophie is an avid downhill skier in the winter and plays competitive soccer in the summer. Lately she has been experiencing pain in her lower back and right knee. Sometimes the pain is intense enough to prevent her from playing sports. My friend recommended I take Sophie to a chiropractor to get fitted for custom orthotics as her daughter had similar issues. What are your thoughts?
Mrs. Thomas

Hello Mrs. Thomas,
If the pain persists even with a couple days rest, then a professional diagnosis by a medical doctor is a priority. This will allow you to start on a plan of action to get Sophie better sooner than later...

Custom Orthotics

Orthotics are custom-made insoles designed to correct imperfections in the way someone walks; also known as an individual's GAIT pattern. The underlying principle is that pain and discomfort in other areas of the body such as the knees, hips, lower back and neck are a result of something in the foot not functioning properly. The foot is the base or foundation for every step we take. If its' joints are not in proper alignment, the rest of the body suffers. Orthotics are designed to put the foot in correct alignment.

My Thoughts and Opinions of the Efficacy of Orthotics

Mrs. Thomas, (assuming Sophie's pain is related to her feet), please keep in mind that my opinions on orthotics are somewhat contradictory to traditional theories. I will give you my opinion (since you asked) and you can decide which way to go.

I agree in principle to the theory of correcting body alignment starting at the foot. Many people wear orthotics because they have been told that they over-pronate or have flat feet. Others wear them to correct for an exceptionally high arch or rigid foot. In all cases, the orthotic is designed to place the foot's arches in the correct position as the individual walks or runs thereby creating total body alignment from head to toe.

What I don't agree with is the method of correction. I do not believe that placing a rigid orthotic beneath your daughter's foot will actually help her in the long run. It may artificially correct her arch while she wears it but what happens when she goes barefoot or can't fit it in the footwear she's wearing? The fact is the orthotic may have corrected the symptom, not the cause of the misalignment. In my opinion, the cause may be related to poor foot function due to weakened muscles in the foot and lower leg.

My Suggestions
I am strongly in favour of strengthening muscles to add support to a joint as opposed to using an artificial device such as an orthotic. Compare it to someone who comes to me with a lower back problem. I would not give them a back brace to wear for the rest of their life. Rather I would suggest exercises to increase flexibility in their back and strengthen the muscles in their stomach and lower back. I believe the same should be done with your daughter. She needs to strengthen the muscles in and around her feet and ankles as they are responsible for setting her arches as she walks and runs. I also suggest she strengthen her stomach and lower back muscles and continues to keep them flexible.

Final Thoughts
Another important factor to consider is Sophie's age. The body's limbs and joints grow at their own pace. It is something that you can't control. Her pain may simply be a result of a growth spurt. If you decide to go the orthotic route, I still suggest Sophie do exercises to strengthen the muscles in her lower leg, feet and core.

Reggie Reyes is a certified kinesiologist and personal trainer. He is the president and founder of pt4kids, a company that creates specialized training programs for kids all ages and fitness levels.

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AdviceMama Says:
Start by teaching him that it is safe to do so.