Excessively pronated feet: a health hazard to developing children

Abstract

There is a serious misconception on the part of the public as well as amongst a great number of professionals to equate the problem of “flatfoot” with excessively pronated feet in growing children. This is a matter of grave concern since flatness of the arch of the foot can be a normal or abnormal finding in foot posture, whereas the excessively pronated foot is flattened as part of a pathological structural malposition. This inherent biomechanical defect is commonly present in the great majority of human children and is the basic reason for most postural pathology of the lower extremity.

Excessive pronation of the feet in children should in no way be interpreted as a “normal” condition to be automatically outgrown. As a matter of fact, Whitman, the famous Orthopaedic Surgeon, noted in 1917 in his text Orthopaedic Surgery that pronation of the feet commonly seen in children is more likely to worsen than improve over the years. This paper presents the probable cause of the condition, treatment and prevention of the problem and recommendations for the future.

The deforming foot posture known as “excessive pronation” is familiar to Podiatric Medicine and to Medicine generally. Yet, in spite of this familiarity, only an insignificant number of the millions of children in our country receive the simple available help required to minimize the problem.

The Podiatric profession has within its grasp the wherewithal to correct this situation, through education and counseling of parents, through cooperation with pediatricians and other professionals and by utilizing technological advances in children's footgear and orthotics. It is the intention of this paper to provide an overview of the literature and history associated with the problem of excessive pronation in children, as well as to suggest some simple techniques for improving this situation.