My Child Walks Funny – Do They Need Orthotics?

Parents are often the first to notice that their children might walk awkwardly and they are not quite sure where to start with correcting the problem. It is often not a problem that the child will grow out of and the longer the problem exists the more difficult it will be to correct. Although parents may think their child’s poor walking problem arises from something wrong with the feet, usually gait problems in young children come from poor muscle dysfunction at the pelvis, although both could co-exist. Poor hip muscle function commonly develops where the child “W” sits – knees turned in with the feet out to the side (as shown in the image below).

Habitually sitting like this results in short hip internal rotator muscles resulting in the child walking “pidgeon toed” or having a “toed in gait”. This style of walking places the hip external rotators and gluteals in a position of poor mechanical advantage, thereby leading to weakness in these muscles and therefore the child is not strong enough to turn the hips out and walk straight – and so the problem continues. This type of walking needs to be corrected early because if it continues for a prolonged period and especially into adulthood, there may be a higher risk of knee or hip osteoarthritis.

Common signs that your child has poor hip muscle dysfunction are:
(a) A preference to sit in the “W” position
(b) Clumsy or frequent tripping
(c) A preference to favour the use of one leg (the stronger) on stairs
(d) Are poor or slow runners with an awkward running action.

incorrect sitting position for childrenBecause the hips are more likely to be the cause rather than the feet for walking problems in children, the best place to start is an assessment with one of our physiotherapists at Sport & Spinal Physiotherapy at Gungahlin Canberra. We have physios that specialise in injuries or developmental problems in children. Our physios will assess the structures around the hips of your child as well as look at your child’s foot function. If indeed, there is a problem with the feet, your physio can then refer your child onto one of our podiatrists for shoe advice or orthotics. In some cases, just having the correct type of shoes is enough to correct the biomechanical problem in the foot. In more extreme cases, your child may need orthotics to realign the foot.

For hip muscle problems, your physio will stretch the tight hip internal rotators and provide some exercises to strengthen the hip external rotators around the gluteals. We use the word exercise loosely here as treatment will usually be in the form of fun games for your child or otherwise we find children are less likely to do them. The first step as a parent is to immediately stop sitting in the “W” position and encourage your child to sit X-legged. You may need to start a reward system to keep your child motivated.

If your child does have gait problems, please call Sport & Spinal Physiotherapy Gungahlin Canberra on 62624464 to arrange for an assessment with one of our physios. Alternatively, if you need more information about how your child walks, we are more than happy to provide some advice over the phone.

About Craig Honeybrook

Craig is the practice principal of Sport & Spinal Physiotherapy. He attained a Masters in Sports Physiotherapy degree in 2000 at Sydney University studying foot injuries in runners and anterior knee pain in cyclists. He has been working as a physiotherapist for over 20 years and moved to Canberra over 12 years ago. He has been consultant physiotherapist for Balmain Rugby League, Eastern Suburbs Rugby, Australian Track & Field and Brumbies Rugby. His special interests include lower limb biomechanics, spinal instabilities and malalignments, bike fitting, running assessments, shoulder injuries and knee injuries. Craig was a former international level middle distance runner but now enjoys endurance mountain biking achieving a 2nd placing in the 2010 World Solo 24 hour Mountain Bike Championships. He also enjoys skiing, swimming, kayaking, gym work and spending time with his family.