Friday, May 16, 2008

About leg pains and what to do?

I had this discussion with some friends on our google group and I thought I'll share the information that I learnt from an extremely beneficial session with a physical therapist at Vansh's school recently, here as well.

She began by telling us about flat feet. Babies and toddlers typically have flat feet and the arch in the feet develops with age, typically between 4-6 years. If the arch doesn't develop well, it
is associated with pain in legs or feet. I would like to mention this here, though I asked the PT at a later stage, that Vansh does complain of pain in his legs after he has had a tiring day and though its not happened for a few months now but starting at about a year back, there were some times when he would even wake up crying at night complaining of the pain. Discussing it with the triage nurse over the phone had led us to the conclusion that since the bones grow, a lot, at this age, especially during growth spurts, the muscles stretch to keep up with the bone growth leading to pain and that its pretty normal. At his 2 year well child visit, the pediatrician had pointed out that its common for children at this age to have flat feet and the arch takes some time to develop but neither of us had talked about its implications. It was when this lady was talking that I remembered having flat feet myself and complaining of severe leg pan often till the age of almost 9 or 10. She said that growing pains usually happen between the age of 5 and 8 and before that it usually is flat feet which causes the pain.

She talked to us at length about what can be done to take care of the flat feet or more specifically to speed up good formation of the arch.

The first thing to do is simple balancing exercises. When you put the socks/shoes on your children, ask them to stand up, put one foot on the palm of your hand (easier while you are sitting down) and let them be like that for a few seconds. Make a game out of it where they
cannot lean on/hold you or something else for support. Increase the length of time gradually.

Ask them to hop on one leg and then change legs.

The second thing she emphasized was the importance of a correct pair of shoes. A lady in our class said that her daughter's pediatrician had told her that it didn't really matter what kind of shoes the child wears because their primary function is to protect the foot from weather, dirt et al. According to the PT, this was far from true. She had gotten an actual foot bone structure with her and showed the bones a good shoe ought to provide a good grip on. Don't quote me on this one because she was showing us the bones without taking the names but according to the picture on the left, they were the Calcaneus Cuboid (the heel) and Cuneiforms and the Tarsal-metatarsal joints (the middle portion of the foot). And the shoes that do that the best are the good old shoes with laces. Also if you look carefully, you would find shoes with an in-built arch (usually all running shoes do). Compare the two shoes below and you'll know what I mean.

Slip ons or shoes with Velcro or even sandals are okay occasionally but not on a regular basis. Its good to let children be barefoot at home or wherever possible outside but when they do wear shoes, its important that they wear the right kind. And the right shoes doesn't mean expensive shoes, just carefully chosen ones. Although I had no idea when I picked up Vansh's Osh Kosh shoes from a discount store for I think 11 dollars, but I was so glad to find out that they did fit the description pretty well.

Last but not the least, she asked us to be extremely watchful about the preferred sitting position of the child. They must be discouraged to sit in the W position (click for what it looks like). Its very common in young children but the PT emphasized several times that it MUST be
discouraged. It can lead to severe orthopedic problems later on. It was surprising for me because it looked somewhat like the aasana in yoga in which you put your heels underneath the hips in a sitting position but with a difference that the heels are not actually underneath but turned out. And try doing this yourself - first sit in the aasana position and see how much control you have over your trunk -the range of movement that is and the area you can cover when you stretch your trunk muscles and your arms and then in the W position and try to pick up things slightly out of reach - the trunk gets locked so to say and in kids that translates to those muscles not getting developed. As also feet problems later on.

Here's a pretty good link for more info


Anu said...

Hey Neera,

That's a wonderful post..Very informative and addresses so many things i wonder about :) A has a habit of sitting in the W position and we have to constantly dissuade him..earlier i used to think v r just nagging him, but now i know! Can u tell me which is a good place for affordable kids shoes around here?

PG said...

A good post neera, very informative indeed! I had also recently read that children have pain in legs while they are growing and I went Like, ooh so, that is why i had pain in legs for so many years as a child. My parents took me all kinds of doctors because of the pain. But it vanished after a couple of years on its own. But, that it could have something to do with flatfeet (As my feet are as flat as they can be!)is very new to me and very very interesting and makes sense.
As for the shoes with an inbuit curve, I have a big problem wearing them, although I've also heard that such shoes are good for those with flatfeet. I have a hard time finidng sports shoes which don't have such a strong curve, as I just can't wear them. It is too painfull und uncomfortable.

Poppins said...

Lovely post Neera, thanks so much for digging up and putting together all this info.

Making Memories said...

really a very informative post neera. but Moon as u know is 3.5 yrs and has proper curved feet, also never complaint of leg pain so far, does it mean he is not growing properly? just curious rather than concerned, exceptions r always there, isnt it?

Neera said...

anu: Its very common for kids to sit in the W position because its a very comfortable position to get in but not good at all. As for shoes, try the regular stores Target/Walmart. I don't know where exactly you are located but you could also try at the discount stores like Ross and Marshall's for good deals.

pg: Really, I had no idea such shoes could be hurtful for people with flat feet!

poppins: Welcome dear :)

mm: There sure are (exceptions) and Moon is a lucky one :)

Swati said...

Thanks Neera..thank you for doing it for me. Aryan loved sitting in W position. We saw his Ped and he said , as of now the curve in his feet looks ok..cannot call it flat foot till now. He also attributed occasional uneasiness at nights to growth pains.

But I will sure take care about what he wears from today. Thanks.

Orchid said...

thanks for sharing..will sock this away for future reference :)