Customise those insoles

Insoles should be customised to suit a child’s needs rather than bought off the rack. – Photo ©iStockphoto.com/tonyoquias


By BRIGITTE ROZARIO


If your child has a problem with his or her foot, you should see a medical specialist – an orthopaedic surgeon or a podiatrist. And, if you need to get insoles or adjust the height of the heel, the best person to see is not the shoe shop salesman or the cobbler.

You should make your way to an orthotist – a healthcare professional who specialises in orthotics (the medical field that deals with the design, manufacture and application of external devices that help modify the body for better function.

It could be a body brace, insoles for shoes or even customised shoes.

According to orthotics centre MyOrtho Rehab, orthotics can help stabilise a child’s posture by minimising the stress on the child’s feet. If not corrected, the gait abnormality can affect a child’s posture, balance and walking pattern. The child could then have difficulty climbing stairs, keeping balance and participating in sports. The child could also be prone to sports injuries.

Edmund Lee, clinical director of MyOrtho Rehab, is an orthotist and prosthetist by profession. He specialises in children’s feet.

He sees a lot of flat feet cases, as well as those with in-toeing and pigeon toes.

Another common case that he sees is children who have one leg shorter than the other. The orthotist needs to firstly assess if this is caused by the child’s pelvis rotation or if it is because the child is flat footed. It is only after finding the cause that a solution can be worked on.
 

Lee: ‘I believe that we can correct children’s feet.’

“I believe that we can correct children’s feet,” says Lee, whose father and grandfather were also orthotists.

According to him, MyOrtho Rehab gets referrals from doctors as well as walk-ins who hear about the centre from word of mouth.

“When they come in, we would do our own diagnosis to see what is the problem, unless the problem is internal in which case they would need medical attention. If the child needs insoles, we will do a scan, then make casts of the feet to get the right measurements.

“We don’t do surgery at our centre. Basically, what we do is preventive and alternative treatment. We handle the foot alignment with the help of orthotics and the doctors take care of the internal issues,” says Lee.

The rehab centre works alongside podiatrists, physiotherapists and orthopaedic surgeons.

In fact, the centre also sees children with cerebral palsy who need braces, splinting and special suits made; and scoliosis patients who need braces.
 

Feet are scanned by the orthotist. – Photo courtesy of MyOrtho Rehab

Lee laments the fact that a lot of parents don’t notice that their children are not walking properly or are sitting too slouched. It is easier to correct if the parents bring the child in earlier rather than later.
 
However, there are also those who are too eager to bring their child in. Lee says that some parents even come in for help when their child is only two years old. Lee recommends that they come in only after the child has turned four or five.

As the child is still growing, insoles and braces need to be changed periodically.

 

A cast of the foot is made to ensure the insoles fit the child’s foot. – Photo courtesy of MyOrtho Rehab

“For the braces, we are not so worried about them putting on weight as we can adjust the Velcro straps according to the child’s size.

“It can be about every two years unless they have a growth spurt, in which case the brace will have to be changed sooner.

“Ideally children should see us for followups every four months to make sure everything is all right and that they are wearing their orthotics,” says Lee.

A pair of insoles cost RM300-RM700 while the braces cost more than RM2,000 each.

Why not buy insoles from shops?

According to Lee it’s always better to get insoles customised by an orthotist because the ones in the shoe shops will not be the right prescription for your feet.

“You won’t get the result that you want. It might work the way that popping a paracetamol does – it gives immediate help. But, if you’re looking for something with the right support for your needs in terms of prescription for your body, then you should see an orthotist for customised support.

“If children are wearing insoles which are not according to the prescription for their feet, the danger is that it won’t be correcting their feet. Most importantly, they probably will have insufficient support and this can cause over pronation (too much roll of the foot after landing) and supination (insufficient inward roll of the foot after landing).

“I’ve seen that a lot. I have parents coming to see me and saying that they bought the insoles from a shopping mall and immediately they know it offers insufficient support. There is no danger from it but then what is the point of wearing it if it offers insufficient support?” he asks.

According to Lee, a lot of parents go straight to the cobbler to have shoes customised when their child has a problem like one leg shorter than the other.

This might result in the child complaining of back pains if the shoe is not customised appropriately.

Lee laments the fact that Asians still haven’t accepted orthotics as a part of life, like wearing spectacles. “A lot of people in the West accept the fact that orthotics is part of their life. We treat it as a supporting element. We don’t expect them to wear the orthotics every day unless they’re walking a lot.

“I always advise patients that if they are actively walking, travelling or working, then wear the orthotics. However, if they are going for a party or a dinner for a few hours, they needn’t wear it,” says Lee.

He admits that initially there will be discomfort when the child initially wears insoles. It will take some time to get used to it.

“But a child will adapt to it much faster than adults. A child might take one or two weeks to adjust to wearing insoles,” adds Lee.

Lee informs parents that their child’s flat footedness and other problems can be corrected if they consult the right medical professionals. They can also see the orthotist directly, and if they need medical attention, the orthotist will refer them to a doctor.

Lee recommends parents to seek the right professional advice for their children’s feet and gait problems rather than just buying insoles from the shops. He advises parents to see an orthopaedic surgeon, podiatrist or physiotherapist.

Taken from ParenThot, thestar online, www.thestar.com.my.