Pediatrics
Children's feet are still developing, and early attention to problems with gait, alignment, and structure can make a lasting difference. At Cella Foot & Ankle Specialty, Dr. Cella provides gentle, expert pediatric foot care to young patients in Fair Lawn, NJ , treating conditions such as toe walking, flexible flatfoot, in-toeing, and brachymetatarsia. Many of these concerns respond well to conservative care when addressed early, and Dr. Cella takes a nonsurgical approach whenever possible.
Toe Walker (Equinus)
Walking on the ball of the foot or toes, also referred to as toe walking, is fairly common in children who are just learning to walk. Children who continue to walk on their tiptoes past their toddler years often do so because the muscles and tendons in their calves have become tighter over time. Treatment for persistent toe walking often involves a period of casting or bracing to help stretch the calf muscles and tendons and encourage a normal gait. For children between 2 and 5 years old who are able to walk flat-footed, initial treatment is always nonsurgical. In toe-walking children over the age of 5, the calf muscles and Achilles tendons may be so tight that walking flat-footed is not possible, and for these patients a surgical procedure to lengthen the Achilles tendon may be recommended to improve range of motion and function of the foot and ankle.
Subtalar Joint Arthroereisis
A surgical procedure can be performed to correct and treat a flexible flatfoot deformity, mainly in children. Subtalar joint arthroereisis is a minimally invasive procedure accomplished by inserting an implant into the subtalar joint, which is collapsed in a flat foot. By adding this implant, the foot is guided to invert and an arch is created. It can be performed as a standalone procedure or in combination with other procedures, and Dr. Cella will determine whether it is appropriate for your child's foot.
In-toeing
In-toeing is when your child's foot points inward instead of straight ahead while running or walking, and it is commonly referred to as being "pigeon-toed." For most toddlers, in-toeing is painless and can be a normal part of development. Three conditions that can cause in-toeing are metatarsus adductus, in which the foot turns inward; tibial torsion, in which the shinbone turns inward; and femoral anteversion, in which the thighbone turns inward. In-toeing can often be corrected with bracing and custom-made orthotics.
Brachymetatarsia
Brachymetatarsia is a condition in which there are one or more abnormally short toe bones (metatarsals). It may result from a congenital difference or be an acquired condition, and it most frequently involves the fourth metatarsal. When it involves the first metatarsal, the condition is known as Morton's syndrome. Treatment involves a number of different surgical procedures, all performed to increase the length of the bone so that the foot can look and function correctly. Dr. Cella will discuss the options and help you decide on the best approach for your child.
Frequently Asked Questions
When should my child see a podiatrist?
You should schedule a visit if you notice persistent toe walking, in-toeing or out-toeing, flat feet with pain, frequent tripping, uneven wear on shoes, or any complaints of foot or leg pain. Early evaluation allows problems to be addressed while a child's feet are still developing.
Is toe walking something my child will outgrow?
Many toddlers walk on their toes as they learn to walk and outgrow it naturally. If toe walking persists past the toddler years, it may be due to tight calf muscles and should be evaluated, since early treatment with stretching, casting, or bracing is often effective.
Are flat feet in children a problem?
Flexible flat feet are common in young children and often painless. Treatment is usually only needed if the flatfoot causes pain, fatigue, or difficulty with activity. Dr. Cella can determine whether supportive measures or, in select cases, a corrective procedure is appropriate.
Can in-toeing be corrected?
In many children, in-toeing improves on its own as they grow. When treatment is needed, bracing and custom orthotics can help guide proper alignment. Dr. Cella will identify the underlying cause to recommend the right approach.
Does my child need surgery for these conditions?
Most pediatric foot conditions are treated without surgery, using stretching, bracing, orthotics, and monitoring. Surgery is reserved for specific cases, such as severe tightness of the Achilles tendon or structural conditions like brachymetatarsia, when conservative care is not enough.
Are custom orthotics safe for children?
Yes. Custom orthotics are commonly used to support proper foot development and correct alignment issues in children. They are made specifically for your child's foot and adjusted as the child grows.
How are children's foot problems diagnosed?
Dr. Cella diagnoses pediatric foot conditions through a physical examination, observation of your child's gait, and imaging when needed. This allows her to recommend a treatment plan tailored to your child's stage of development.