WHY “Good Posture” is So Important for School!

by Dr. Ali

We are always hearing about “good posture” and how important it is for us. We hear “sit up straight” and “don’t slouch” often, whether you are saying it to your kiddo or you hear another parent or a teacher saying it to another kiddo. What is never partnered with these phrases is WHY this is so important. I wish that as a kid, somebody told me why sitting up tall was so important, because if they had, maybe I would have done it more instead of slouching!

Sitting with supported, aligned posture is SO important for every body, and for all mobility statuses. If you are curious as to WHAT good posture looks like, click HERE to read a blog post all about appropriate postural alignment and for some solutions to help with sitting posture throughout the school or work day. 

It’s also important to remember that a “good posture” is also one that you’re not in for too long!  We want to empower our kids to listen to and respond to what their bodies need- that may be using a standing desk for periods of the day or sitting on a wedge to support a more traditional aligned upright posture. However, we do want all of our kids to have the flexibility and postural control to sustain an actively aligned posture for periods of time.

SO, without further ado, we are here to tell you all about one of the BIGGEST benefits of sitting with nice, spinal alignment. And what is this benefit you ask? BREATHING! Sitting with your spine in a properly aligned position makes sure that your ribs are in the right places to allow for proper expansion when we breathe in. Sitting with our core activated, with our ribs and spine in a proper alignment ensures that your diaphragm (the big muscle that attaches to your ribs and sits below your lungs) is in the perfect position to contract and relax for breathing. With your ribs and spine in the right position, your lungs have enough room to expand and let in all the air they can. Then your breathing muscles (the diaphragm and more) are in the best position to bring in all that air (aka a win win)! When you sit up TALL, your breathing is not SMALL! 

So, WHY is breathing efficiently important for effective learning throughout the school day? Breathing in big, natural breaths gets oxygen into our lungs, which then gets taken all over the body. Our brain needs oxygen to think all the thoughts we need for our school lessons. The heart needs oxygen to keep beating with a strong and healthy rhythm. The arms and legs need oxygen to fuel their muscles to move and groove or patiently raise a hand to answer a question. The stomach and intestines need oxygen from the blood to digest your yummy lunch so you can turn it into energy! Basically, the WHOLE body needs oxygen to keep on keeping on and to continue doing what each part is supposed to do!

The body needs oxygen for SO many things! And not just any amount of oxygen, but the right amount of oxygen. If the lungs fill with too little oxygen, then the body is only working off of what it has, and maybe compensating for the energy it is missing. You may feel tired throughout the day, with lots of yawns and trouble focusing. This is something we definitely want to avoid when our kiddos go back to school! When they go to school for the day, we give them a hearty breakfast in the morning to make sure they have enough energy to last them until lunch time and a hearty lunch to get them through the rest of the day. BUT both of these amazing meals are not going to help them combat the tiredness they will feel if they are not breathing right all day long at school because of poor posture. 

Good posture and optimal breathing supports emotional regulation, by increasing access to the parasympathetic nervous system, the opposite of our “fight or flight system.”  It impacts a child’s ability to use their eyes, especially for desktop work, but also the ability to move back and forth between looking far at the teacher and looking close at desk work.  It also impacts handwriting and other fine motor skills. 

Our ability to sustain our posture over a long period of time is not only the result of the chair we are sitting on but also our body’s ability to sustain “good posture” using our muscles and sensory system. Some kids have a hard time with the muscular endurance or strength required for good posture. Others have a hard time sensing where their body is when sitting and thus sit in a very relaxed, forward curved posture. Some kids have a combination of both of these factors (and typically this is the case). If you notice your child sitting with slouched posture at home, you can probably assume they are sitting that way at school. If they are sitting that way at school too, they are not breathing in the most efficient way and may not be getting the proper amount of oxygen throughout the day for peak concentration! If you feel like this is your child, it is not something that can’t be helped and improved with physical therapy! Through physical therapy, your child can learn to support their body with supported posture and build the muscle strength and endurance to hold that posture for much longer stretches of time. If you feel like your child spends a large part of the day slouching when they sit, do not hesitate to call us at KidPT to schedule a free Discovery Visit so that we can screen your child to see if PT is appropriate for them, and if we are a good fit, to help them learn to sit with ease!

It is almost back to school time! You must have a lot of things on your plate between enjoying the last few glory days of the summer and also preparing for the start of a new school year. So we have made it easy for you with a quick guide of things to consider when purchasing a backpack.

Although the stores are stocked with bookbags with cool colors, designs, and beloved cartoon characters, try to avoid only considering the style and appearance when purchasing a bag for your little ones. Research has shown that heavy and inappropriately fitting backpacks can alter posture and alignment and place stress on the musculoskeletal system leading to neck, shoulder, and back pain or injuries with repeated use. Our bodies are complex and dynamic with many systems working together. When one area or system is stressed or overloaded, the body adapts with compensations in other areas. Unfortunately, repeated use of poorly fitting or heavy backpacks can lead to inappropriate postural alignment compensations and stress down the structural chain of the body. Since bookbags are used by our kiddos for a significant time throughout the school year, it is important to take steps to ensure appropriate use to avoid injury or compensations.

A few key concepts to follow when choosing a book bag are to increase the amount of contact area between the child and bag, minimize and distribute the weight, ensure symmetry, and keep the load as close to the trunk as possible. Below are characteristics to look for and practical tips to assist you on this back to school endeavor. 

Optimal backpack characteristics:

  1. Two wide shoulder straps
  2. Padded back and shoulder straps
  3. The width and length of the bag should not be longer than the child’s trunk
  4. Backpacks that buckle at the chest and waist help distribute weight from the spine to the pelvis and chest
  5. Multiple compartments to assist with weight distribution

Optimal backpack use and tips:

  1. Weighs less than 10-15% of your child’s body weight
  2. Frequently check the weight and remove unnecessary items
  3. Involve your child in the process to promote independence with healthy habits
  4. Ensure that it sits in the middle of the back and aligns with the shoulders and hips
  5. Place heaviest items and books towards the back of the bag so that they are closest to the child’s body
  6. Tighten straps so that the bag is closest to the child’s body, but also allowing free movement of the arms while wearing it
  7. Bend at the knees and hips instead of the back when picking up the bag
  8. Wear on both shoulders and avoid bags that rest on only one shoulder
  9. If standing for a long period of time, have child place the backpack on the ground to unload their spine
  10. Lastly, make sure your child has multiple opportunities to engage in play and physical activity throughout the day to build strength, endurance, and postural control

Signs of poor fit and use:

  1. Numbness, tingling, discomfort in arms or legs
  2. Back/ neck pain
  3. Posture changes with forward head and rounded shoulders
  4. Difficulty putting backpack on
  5. Limited arm movement when backpack is on
  6. Red marks on skin

Please do not replace medical advice from your primary care physician, orthopedist, or physical/ occupational therapist with the information presented in this blog post. Always consult your medical team with medical advice.

https://www.choosept.com/resources/detail/backpack-safety

https://cdn.ymaws.com/www.ccapta.org/resource/resmgr/imported/MCBackpackSafety.pdf

by Dr. Ali

This week we are going to get BUGGY! There are two different types of people out there, those who think bugs are really cool and helpful and those who think bugs are the scariest beings to walk on earth. Although bugs may not be some people’s favorite things, there are so many out in the summer, doing their little buggy jobs here and there. They are all so different from each other in shape, color, and especially in HOW THEY MOVE! Because of this, we thought it would be fun to bring you and your kiddos BUGGY MOVES this week!

The Butterfly Flap:

  1. Stand up tall with your “wings” (arms) out to the side
  2. Stretch your arms up all the way to the sky
  3. Flap your arms sideways and down until they are at your sides
  4. Keep repeating this until you have flapped your wings 10 times!

The Super Ant Pick Up:

  1. Fill up a laundry basket FULL of “food” (clothes, whatever works)!
  2. Pick up the laundry basket
  3. Carry the laundry basket all the way to your “ant hill” (your room)
    1. Make sure to tell your kiddos about how strong ants are and how much they can lift to inspire them to act like an ant!
  4. Repeat this 5 times total so your ant colony has enough “food” for the week!

The Jumping Spider:

  1. Start in a crouched position on the ground (hands and feet touching the ground)
  2. Scurry forward in this position and count to 1,2,3!
  3. After the count of 3, JUMP into the air JUST like a jumping spider does
  4. Repeat this 10 more times for 10 spider jumps!

The Scooting Worm:

  1. Lie on the ground on your tummy with your arms up next to your ears. Make sure you have enough space to travel in a long line on the floor and that there is no clutter in your way!
  2. Crawl your knees in, bent so that they get closer to your tummy. You will then be kneeling in a child’s pose.
  3. Slide your arms forward until your tummy is on the ground again!
  4. Repeat this 3 times, then turn around and come back to where you started.

We hope you enjoy these summer bug-tastic exercises! We know you are “bugging” out that summer is almost over (so are we) but we are trying to enjoy every last bit. Happy summer everybody (and every buggy), have fun squirming, jumping, and flying like our little friends do!

It is SUMMERTIME and with summer comes many fun outdoor activities.

One of these is Swimming!

Swimming is great for any kiddos who have low tone, neuromuscular conditions that affect movement strength or control, and for conditions that affect one’s joints. For any child who falls in one of the diagnostic categories listed above, moving in the water helps because buoyancy (aka what helps you float a little bit when you swim) takes away some of the gravity that typically weighs us down when we move! Though we love gravity to help keep our feet grounded when we move around on the earth, it does make it more difficult for kiddos who have low tone or neuromuscular related weakness to perform tasks that require them to move against gravity or require their muscles to have to sustain endurance against the forces of gravity throughout the day. For children who have a condition that affects their joints, the buoyancy of the water relieves a portion of the downward pressure exerted on their joints with every step on land. 

Now, while buoyancy makes time in the water a little easier than time on land, we can’t forget about the other properties that make exercises in the water a true workout. Water is more viscous than air, meaning it is thicker and harder to move through. Not only is water thicker than air BUT water molecules love to stick together too, a property called cohesion. When the molecules stick together, again it makes them harder to move through than air, because as we are moving through water, we are resisting the force required to maintain the bonds between water molecules. I’ll bet you never thought you were breaking bonds every time that you go for a swim, but it’s neat right?! 

That said, here are some activities that your kiddo can do in the shallow end of the pool (with supervision of course) that will help strengthen them for their time as a landlubber (aka when they are on land again):

  1. Water walking OR running: Perform this in the shallow end only. This activity involves the whole body and will help get the heart rate up as well
  2. Jumping jacks: As you move your arms upward and jump with your legs apart, you wil be able to feel the water helping your arms and legs rise BUT as soon as you try to pull everything together you will feel an increase in resistance (the opposite of being on land)
  3. Swimming: Whether they are doing the doggy paddle or repeated strokes of freestyle, they will be cutting through the water working with all the properties described above and building strength and getting their heart pumping!
  4. Water punches: Have your kiddo stand still and pretend they are attacking some bad guys as a cool secret agent. To up the difficulty level, you can add in turns and tell them the bad guys are all around. Make sure they are punching under the water or else they are not benefitting from the resistance the water can provide.

Want to learn about more fun exercises for Summer? Visit our instagram @KidPT or check out more of our blog posts!

by Dr. Ali

Toe walking is something that is frustrating for many parents and their kids and our parents are often worried about their child’s balance or overall joint health of their feet and ankles as they age. The children are frustrated with always being told to walk on flat feet when they feel like they really can’t control how they are walking! We often hear “They’ll walk on flat feet when they’re thinking about it, but as soon as they stop thinking about how they are walking, they are back up on their toes again!” We hear this over and over again from parents. If you have been to another physical therapist for your child’s toe walking, often they just stretch, stretch, stretch them… your child is miserable and in pain AND there is often no change in their toe walking.

We look at toe walking a little differently. The body is a movement system if the system is not moving the way it is designed to, there must be a reason! The important question we therapists always ask is WHY! When a child walks on their toes, they are using a less efficient gait pattern than when a person walks with a heel to toe gait pattern. Our bodies are SMART and they are always trying to optimize their own movement efficiency naturally so that we can move with EASE. Basically all bodies take the path of least resistance, no matter what! That said, if a child is toe walking, it is DEFINITELY meeting an underlying need in their body, or else, they wouldn’t be walking that way. Toe walking IS their body’s path of least resistance. There is something blocking their body from walking with a heel toe gait pattern and making toe walking the easy way to move. THIS is where we pediatric PTs come in! There are many needs that their body might be trying to meet and we are here to help them fill in the little gaps that their body has not been able to do alone (up to this point). 

Postural and Biomechanical 

Sometimes, the origin of a child’s toe walking is related to their alignment and the way a child uses their core. When this is the primary reason for a child’s toe walking, we will often see the child leaning forward, belly out, with their whole center of mass (aka the middle of their body) positioned forward over their feet. If this is the primary driver of a child’s toe walking, then they need to re-learn how to use their belly muscles and how to re-align and control their whole body while moving before any changes are seen at their feet and ankles. 

Sensory

Sometimes toe walking can have a large contribution from the sensory system. Within this realm there could be multiple different sensory needs their toe walking may be meeting. Let’s look at these different needs a little more: 

  • Tactile: Often the link between toe walking and tactile sensations (aka what you feel when something touches your skin) is related to something called tactile defensiveness. Simply put, if your child is tactile defensive, they dont like the way some sensations feel. If your child doesn’t like certain sensations and their toe walking changes when they walk on grass versus concrete or tile versus carpet, and etcetera, there could be something relating to their tactile system that is contributing to their toe walking.
  • Visual: The development of the visual and visuomotor systems are tricky overall. As a child develops, their eye movements become more and more coordinated. By the age of three, most children have started to develop more mature visuomotor skills, like convergence (when the eyes work together to see things that are low and in the foreground). When we hear that a child did not start toe walking until about the age of three, we often suspect there is a visuomotor factor at play, though other factors may be present as well. If there is a visuomotor component, we typically refer the child to a professional called a Developental Optometrist who is the ideal healthcare provider to determine whether the eyes are coordinated and if eye movements are developmentally appropriate or if they are in need of a little help!
  • Proprioceptive: when a child is trying to meet a proprioceptive sensory need by toe walking, they may be walking on their toes to gain extra sensory input from their feet. Proprioception is a sense we have in our muscles and joints that tells us where our body is in space. This is why proprioception helps us feel safe and grounded, because we can understand where our bodies are in relation to our environment. Sometimes, if a child has a proprioceptive system that is not accurately processing, such as with a child with low tone, the information the body is trying to give, the child may be unsure of where their feet are and their legs are in space when their feet are flat on the ground. Their innate solution for this is to rise up onto their toes to press the joints of the feet and ankles together, which then gives them more info about where their legs are.

Neuromuscular:

-Sometimes children who present with high tone or low tone can toe walk based on how their system regulates the tone in their muscles. High tone is frequently seen in children with Cerebral Palsy or children who have had a Traumatic Brain Injury, and in this sense, when the child moves or tries to walk, the tone in their calf muscles may increase to the point where they are walking up on their toes. In the case of low tone, similar to why children with impaired proprioceptive systems might toe walk, the child might be looking to stabilize joints which are more mobile. By toe walking, children with low tone are increasing their overall joint stability and thus the stability of their body while they move. Neuromuscular contributions to toe walking are more complicated as they require more time, patience, and retraining of the way the child regulates their tone while they move (which is often an automatic process and is only slightly understood by the medical community). The main reason why toe walking can be troublesome for this population, especially in the case of high tone, is that having the foot and ankle positioned in a pointed position while moving and likely while standing or resting too can create something called a contracture. A contracture is the term used when a joint loses movement in a certain direction to the point where it affects the intended function of that joint. When a contracture gets too severe, it might cause skin break down while a child is walking in certain shoes, which could lead to an infection down the line. Contractures are very hard to reverse once they occur and prevention is typically the preferred way to go!

If ANY of these descriptions (or a combination of these) sound like your child, they may benefit from physical therapy with the knowledge of how to treat idiopathic toe walking. Gone are the days of “stretching three times a day will make it better” because if you have done this with your child you KNOW that 9/10 time this does not work. At KidPT we treat idiopathic toe walking from the tummy out to the tips of the toes and don’t look over the potentially crucial contributing sensory factors. We will work with you and your child as a team to put the puzzle pieces together (and oh yeah did we mention they will have FUN while doing it). Stop stressing and start getting answers, come in to KidPT today for a Free Discovery Visit and see if WE are the right fit for YOU!

There are many fun activities your child can do on the playground to help facilitate gross motor development, develop coordination skills, and increase overall body strength. Below are just some examples of how to do this to get you started:

Playground Stairs & Ramps: Many playgrounds are equipped with a set of stairs that take kids all the way to the tippy top of a slide. Many of them also have landings that are the perfect height off the ground to allow the kids to jump down (this would be a height of around 16 inches). Practicing this skill lets kids use two feet together to take off and two feet to land at the same time. If they haven’t yet mastered a two footed landing, practicing by jumping down will help with the development of this skill!

Climbing walls: Many playgrounds have climbing walls these days (which is really cool). Climbing walls are a great way to use and develop a child’s upper body and lower body strength, core strength, and whole body coordination. They have to use their brain to figure out where to place their feet and hands and then coordinate what they have figured out with their bodies to get their bodies to execute each motion. It’s a whole body team work activity!

Swings: Swings provide a great foundation to work on postural control and balance using many muscles of the trunk, legs, and arms to do so! The swinging motion requires a child to move their body in opposition to the motion of swing to continue to generate momentum. Each transition of their body between back and front uses a give and take of the front versus the back muscles that help support their spine, hips, shoulders, and etc. Negotiating their body in this way helps teach them how to use these postural muscles and how much to use on each side to create a desired movement. In other words, it teaches them how to coordinate these muscles. 

Tubes: Tubes are a great way to build upper body strength and use the core in a way we typically don’t once we learn how to walk. You can encourage your child to be creative with their movement in tubes too, not only crawling forward but crawling backward, moving in a bear crawl, trying a commando crawl (on their belly), or even crab walk!

Slides: Last but not least, slides are also a great tool to help develop body strength and coordination. When a child slides down a slide, they have to keep their body upright in a sitting position. While they are doing this, inertia is pushing their trunk backward and they have to use their core to stay upright! When they land at the bottom, they again have to coordinate the front and back core muscles to keep from falling forward as the force of inertia is decreased on their trunk (when the movement stops). They also must stop themselves with their legs without losing their balance, which requires a lot of strength, control, and coordination of the legs and body!

We hope you have so much fun on the playground this June! Remember to always supervise your kiddos while they are playing and stand close to them while they are trying new and difficult skills, in case they need your help! At the same time, remember that the playground is the perfect place for kids to take risks, challenge their skills and learn how to problem solve.

If your kiddo is having trouble with coordinating or performing some of these gross motor skills, give us a call at KidPT to schedule a free Discovery Visit today! We would love to talk to you about your child’s potential PT needs!

Happy JUNE! June is in full swing and with this fun Summer month comes warmth, and lots of SUNSHINE! To celebrate this sunny month, here are three fun in the sun exercises to get ready for summer! Yay!

  1. The Sunbeam Stretch: Start with your body in a little ball and streeeeetch up tall toward the sky to feel like beams reaching out from the middle of the SUN! Repeat this 10 times to create 10 shining sun beams!
  1. The Sprinkler Jump: Pretend that there are sprinkler beams spraying near your ankles (or get out a real sprinkler). Jumps sideways over the water streams! Repeat this 10 times to each side and try not to hit the water (whether it is real or imaginary)!
  1. The Sunscreen Slide: Grab your bottle of sunscreen, hold it in one hand, then do a slide with arms out before putting the sunscreen on your face (imaginatively) when your feet come together! Repeat this one 5 times to each side to evenly honor the skin saving lotion in your hands!

We hope you have fun doing these three simple activities and that you are excited for the start of SUMMER!

Did you know… there may be a link between your child’s core control and their level of anxiety? When we learned about this link, it just about blew our socks off… and then we quickly put them back on because it made so much sense to us! 

People are always saying that core control and strength is SOOO important for kids and adults to move efficiently and to support our bodies. This is true and when someone has difficulties keeping their bodies stable and centered in one place for a bit of time, it is often related to their core strength or core control. This we usually expand beyond the idea of the core alone and relate this difficulty controlling the body to the term “postural control”. If you read our blog on a regular basis, you know that we talk about postural control ALL THE TIME! We talk about it so much because it is so important to everyday life and our ability to move through it with ease. If we can’t control our bodies in a still state, hold our bodies in an aligned posture, and activate our core in the right way, performing higher level tasks is HARD! If your child is focusing SO much on maintaining control of their body, any tricky coordination or tricky mind components of the task may be a very big ask and that specific task may be very hard for them to do.

We see this and recognize this in many of the kiddos we treat, which is why we are always mindful of adjusting a task to meet them where they are at that given point in time. Although we are always thinking in this way, what we hadn’t necessarily thought about was how difficulty with postural control and core activation may be linked with emotions, specifically elevated levels of anxiety.

HOW you ask? In a study performed comparing the balance and postural reactions of children with anxiety to children without anxiety, it was found that during simple balance tasks, children with anxiety exhibited greater postural sway with less variety when compared to children without anxiety. The differences between the two groups grew larger as the balance tasks became more challenging. The researchers concluded that the pattern of postural sway they saw suggested that decreased stability during balance tasks causes the task to demand more attention. This, they felt, may explain the link between decreased balance and higher levels of anxiety in children.

SO, if your child has more trouble controlling their posture at baseline, they may be devoting more attention to postural control at all times. When they send more attention to their body in that way, it takes up cognitive power that they need to complete hard school tasks or that they need for harder motor tasks… AND life demands them to do these higher level tasks ALL THE TIME. This has the potential to increase their anxiety and overall frustration when asked to do these challenging things. As is stated above, researchers predict that this may be why these two things are linked, because the mind is being forced to devote attention to SO MANY hard things all at the same time, and that shifting attention in this way is STRESSFUL. This is especially so because as children shift some of the attention they are giving to maintain their  postural control away from the body and toward another task, they may start to lose their balance, forcing the brain to give that attention back AND then they complete the big task in a slightly haphazard way. 

If your child has trouble with balance, they may benefit from physical therapy. We look at each child as a whole being and consider more than just the basics of balance and strength, because we as human beings are so much more than just these things! If you are curious about physical therapy for your child and want to test the waters, come in for a free Discovery Visit to see if we are the right fit for you, your family, and your child. Don’t worry, there are so many things in life that make us stressed and nervous but we have your back and we are here for you! Breathe in and out , everything is going to be okay!

Resources:

https://behavioralandbrainfunctions.biomedcentral.com/articles/10.1186/1744-9081-5-42?fbclid=IwAR3HNmXlyiwQSHMpyudJy0_i-IMCPkPlp6bWFzlL0eIB5n92I3st-kxcSWM#Sec19

Everyone is always saying “Exercise is good for you!”… yeah yeah we’ve all heard that before. We know that exercise makes our bodies healthier BUT did you know it can make your mind happier too?? This month is National Mental Health Month. We wanted to raise awareness this week by helping you understand WHY exercise can lift you and your child’s moods and help to reduce unwanted stress at the chemical level (aka within the brain)!

When we exercise, our brains release something called ENDORPHINS. Endorphins are released when our body feels physically exerted, which usually happens when we start to sweat, our heart rate goes up, and our cheeks turn pink! When our brains release endorphins, this helps to decrease our responsiveness to pain and also relieves stress within the brain. Also when we exercise, our brains release many mood-boosting chemicals. These are called DOPAMINE, NOREPINEPHRINE, and  SEROTONIN. These brian chemicals are all responsible for regulating our mood and promoting internal happiness on short and long term scales. One of the really cool things about Serotonin is that when we exercise regularly, the levels of serotonin in the brain have been shown to increase over a longer period of time. This promotes a greater sense of well-being, which can help your kiddos feel very secure.

Another great benefit of exercise is that it decreases potentially harmful stress chemicals, specifically adrenaline. With regular exercise, the levels of adrenaline in the brain become more balanced. If your kiddo exercises on a regular basis, this may help them feel less of this hormone which tends to make people very stressed out when over produced. 

We know hormones and brain chemicals can get very complicated very quickly BUT the bottom line is….Regular exercise can make your and your child’s brain happier and less stressed. No matter what that exercise might look like for you and your kids, as exercise comes in many forms for many types of bodies, it is important to move in a way that is healthy for your and your child’s body as much as is possible! 

Looking for ideas to jump start your family’s movement today? Watch this youtube video created by Coach Corey Martin, he will have the whole family ducking, dodging, and jumping over imaginary obstacles in no time!

Information retrieved from:

https://www.healthline.com/health/depression/exercise#Exercise-and-brain-chemistry
Feet are funny, they are those things at the end of your legs that hold up all of your weight all day long. They provide a stable base to balance on and the way they move when you put your weight on them helps you walk in a stable way. 

Feet come in many different variations and all feet are different! As physical therapists, when we take a first look at your child, we always make sure to look at their feet along with the rest of their body. Sometimes the way the feet are structured OR the way they move when your child stands on them can make balance VERY hard. What do we mean by this? Sometimes the feet have a little bit of extra motion to one side or the other. When this happens, the heel will often make a C shape, and that C can either point out or point in when you are looking at your child’s foot from the back. If the C’s point out, with the curve of the C in the middle, they may also have a “dropped arch” or a “flat arch”. If it looks like your child’s arch is close to the ground when you look at the inside of their foot, they may have arches that are more on the “flat” side.

Arches that are on the “flatter” end of the spectrum are not necessarily all bad, they absorb forces nicely when someone walks or runs. With enough foot strength, an arch that is on the flatter side can be very strong and can maintain that strength when challenged by difficult activities like walking, running, jumping, etc. When flat arches DO become a problem is when they start to affect a child’s balance and development of gross motor skills, like standing and walking. 

This is often the case when a foot with a flat arch lacks either the strength, dynamic stability, or both to stabilize the foot in a strong position during weight bearing. This can be seen when the child tries to stand, walk, or jump, where the arches remain in a “collapsed” position despite all the hard work the child is probably doing on top of their feet with their leg, butt, core, and trunk muscles to keep their balance. When this is the concern, we pediatric physical therapists often turn to orthotics and SMOs. When orthotics and SMOs are the right fit for your child, they allow the foot, and body on top of it, to practice dynamic stability. This helps develop a stronger foot while minimizing the effects of gravity that the foot is constantly losing the battle to! Think of it as getting the feet AND the whole body on top of the feet to work SMARTER and not HARDER for the time being! Once given a little extra help in the feet department, many kids take off and achieve milestones and new feats that were previously very challenging from them, because they are stabilizing their feet in a more efficient way.

For children who have a flat arch on one foot and not on the other, these children often have imbalances traveling from higher up in their bodies that are affecting their foot position. These children will benefit from physical therapy exercises, as orthotics won’t address the source of the problem.

If you were thinking about your child while you were reading this, come on in to KidPT for a free Discovery Visit! We can take a look at your child, how they are moving, and at their feet while they are moving! We can let you know what we are seeing and help steer you in the right direction!