Care of Fallen Arches in Children
To prevent an infant from acquiring fallen arches, the single most important thing a parent can do is to leave shoes off their feet as much as possible during the first eighteen months. Consider the following analogy:
Imagine putting heavy leather mittens on an infant's hands from the first months of life, leather mittens which fit snugly, so that the child's fingers are pressed together so tightly he can hardly move them. The mittens are kept on his hands all day, and are taken off only for sleeping at night, for naps in the afternoon and baths once a day. When the child is in the crib we are careful to make sure his hands are tucked so tightly he cannot move his fingers freely. When he wakes in the morning, we immediately put cotton mittens on his hands and place the heavier leather mittens snugly over his fingers once again - day after day.
After two years, during which time the child has hardly ever had the chance to wiggle his fingers, we expect him to begin holding a spoon and cup. He is unable to do it, because all those complex muscles which should have been developing are undeveloped and unused.
Suppose we keep this system up until he is sixteen? It would be ridiculous to expect him to be able to play a violin, use a typewriter, or do anything well with his fingers for the rest of his life, for he would never have developed the muscles he should have during his formative years.
We do just that to babies' toes and feet. Is it any wonder so many of us do not have the strength to stand and walk straight?
Flat Feet and Fallen Arches in Infants and Toddlers Are Normal
Babies appear to have flat feet because of the thick layer of baby fat present in every infant's arch, which is normal and necessary. From this fat, babies muscles and bones absorb nourishment as they grow. It starts disappearing late in the third year, but until then every baby normally has low arches.
Additionally, when baby first starts to walk, he stands with his feet pointed out in a fallen -arched manner in order to balance himself. For a toddler this is normal. When a few months later, he acquires strength (if his feet and toes have not been weakened and distorted by shoes), he will by himself abandon the fallen-arched gait and stance.
Leave the Arches of Flatfooted Infants and Toddlers Alone
Many parents inadvisedly buy corrective shoes for their infants "to correct their flat-footedness." After the child wears these shoes for a year or more his feet become distorted, and such measures seem to have been justified. Parents who have fears about their toddler's feet should wait until he begins to walk firmly and with assurance; only then can real arch defects of the foot be recognized and corrected. Do not make the harmful mistake of treating your infant's or toddler's "fallen arches" when his flat feet are normal to him and should be left alone.
A fourth misconception is that it is not good for a child to have short, square feet, as he will surely have fallen arches. Actually, that is how undeformed feet should look, but since children's feet are so commonly deformed, even most doctors hardly ever see a normal pair and the myth continues. The recent influence of physicians and pediatricians to encourage young children to go barefoot is forcing shoe manufacturers to make older children's shoes in EE and EEE widths. Formerly they made mostly A's and B's. But these broad feet are not "spread" - they have just been allowed to grow as wide as they should naturally grow.
Post-toddlers' Fallen Arches
After your toddler has begun to walk firmly, if he really has fallen arches (you can easily tell by giving him the test explained in Chapter 11) you will be pleased to know that treatment for the young child is very simple, and can easily be carried out at home. Simply put aside all his shoes and stockings and allow him to walk barefooted. You can help by playing with his toes so he will wiggle them more, but in most cases it is not necessary, since the child of two will start using his toes by himself the moment the impediment is removed from them.
In a few weeks his toes will become fatter and stronger. Gradually the child will put his weight on his toes instead of his arches. Soon he will walk with his toes pointing straight ahead, and play about the house with more spring and agility on his feet. . . . .
Fallen Arches: Ages Three to Five
Treatment for fallen arches of these children is also readily successful, but it takes a little longer. The recovery is often as rapid and spectacular as in the following severe case of a four-year-old girl.
A mother brought her into my office. The girl was wearing such stiff arch-support shoes that she could not possibly move her feet inside them. Being tiny, she could not bend the inflexible leather of the shoes with her feet. Upon taking off her shoes, I saw that her feet were mostly bones with very little flesh and muscle on them.
While still an infant, the mother, following one of the local advertisements had bought the child corrective arch shoes. The little girl had begun to cry at night because of pains in her legs. During the day she fell frequently while walking, and she whimpered constantly.
I advised the mother to discard her child's shoes and let her walk barefooted at all times. In a week the girl stopped crying. Her toes became perceptibly less scrawny. During the second week she was walking straighter. By the end of the sixth week, she stopped having pains in her legs at night. She slept soundly, ate better, grew three quarters of an inch, and her feet had become much more muscular and sturdy.
That little girl needed no professional treatment though her arches had been badly damaged. The same is true for most children under six who have fallen arches - walking barefooted appears to be all that is necessary for recovery. Moreover, their skin is sensitive to adhesive tape, and specialized treatment such as steel braces on shoes (Dennis-Browne night splints) can cause harm by restricting the exercise the child normally gets in thrashing his feet and legs about while in bed. There is no harm to await professional treatment -bandaging and exercise - until after the child is six. In any case let him go barefoot and nature will probably make professional care unnecessary.
Four-fold Foot Care for Children's Arches
Helpful as professional care may be, more important is the care practiced by the parents at home. To restate, that care must be four-fold. First, be aware that shoes distort the feet. Do not buy them for the child before he really needs them; then fit them properly. Second, do not wait for the child to complain about foot pains before you see if his shoes are distorting his feet. Third, the child must be given the opportunity to go barefoot for a part of the day, preferably three hours a day. Fourth, you may additionally supervise and encourage the child in doing the foot-strengthening exercises just outlined.