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Children often look very ungainly when they run, with flailing feet and legs. Should parents be worried by this and does it indicate that there may be a problem? What would a podiatrist advise in this situation?

As a parent you always worry about anything that seems unusual in your child.  You spend a lot of time observing your children, partly to make the most of the short time it takes for them to grow up, and partly to make sure all’s well with their development.

Podiatrists often see children brought to their clinic by parents worried about their child’s development. This is often triggered by seeing the child run and feeling that it looked ‘odd’ or maybe they seemed uncoordinated or tripped a lot

Concerns always taken seriously

Any healthcare professional will take such concerns seriously, because if any developmental issues are discovered the outcome is more likely to be improved by early detection.  Also, we all know how such concerns can gnaw away at both parent and child and a thorough examination with full explanation is thoroughly justified in order to allay such concerns.

Skeletal development

One thing a podiatrist will always take time to explain to parents and children is that the legs and feet of a five year old child for example, look completely different to those of a baby or a teenager’s.

These differences reflect the progressive development and maturation of the skeleton.

Consider the legs and feet of a baby – the knees face the sides, while the soles of the feet face each othervery different from an adult’s. So during development, the hips need to rotate so the knees face forward, and complex derotation at the ankle brings the foot into a more plantigrade position i.e. with the sole facing the ground.[1]

These are major changes in the orientation of the legs, feet and joints and take about 18-21 years to complete. 

So it’s hardly surprising that when viewed partway through their normal development children may sometimes look a little awkward.

And in the main, that is all you are seeing when you find your child has an ungainly run. But a visit to a podiatrist may still be advisable to double check, and so they can explain exactly what you’re seeing.

What things might a podiatrist notice?

One of the most commonly seen is flat feet, meaning the foot has a low arch.  A much smaller percentage will present with very high arches – sometimes called a cavoid foot.[2]

Moving upwards, the calves may bow out from the knee to the ankle (tibial varum or ‘bow legs’) or do the opposite with the knees touching and the ankles further apart (genu valgum – ‘knock knees’).  When you look at your child from the side you may notice that their calves bow backwards from the knees – known as hyperextension of the knee joint or genu recurvatum.

Many of these things just represent stages during development so will resolve as the skeleton matures and are not a cause for concern.

But a podiatrist will also test for other things and carefully observe your child walking or running.

Corrective exercises for a proper running style 

A lot of people think that running style is inherited and there’s not much they can do. This is, however, not true. Let's take a look at the most common mistakes children (and even adults!) make when they run and a few tips that can help cure the following mistakes. If you or your child's trainer spend up to ten minutes working on running technique, your child will improve his running technique and will absolutely get faster. 

1. The child overextends the lead foot in order to try to cover more ground. This type of running is very inefficient because the child will continually stop and start.

How to correct it? 

The child should place the foot directly under the hips instead of extending it too much forward. This type of feet placement will help the child run faster and his legs will turn over smoother.

2. The child leans forward at the waist. The problem with this type of body position is that prevents an efficient use of his leg muscles. Another big problem that results from this type of body position is running on his heels instead of the forefoot.

How to correct it? 

The child should stand tall: his ears, shoulders, hips, and ankles are all in the line. The child should slightly bend his knees and then from this position, he should lean forward at the ankles so that his heels are barely touching the ground. Yes, this is the angle they should run at, and also the angle where the feet should strike the ground. A corrective exercise would be to have the child run from this position and maintain the forward lean from the ankles for up 50 meters.

3. Child wastes his energy by swinging her arms or bobbing his head when he runs. The exercise described above (ankle angle running) should help them with the head position.

To avoid arm swinging, the child should hold his arms at 90-degree angle and swing them from the shoulders. This way the hands will swing from the back pocket up to the hips. The child should first exercise slowly, and then he should increase speed. The final stage of this exercise would be to combine this and the ankle angle exercise: add the part of the exercise with arm positioning to the previous exercise with the forward lean.

4. The child is trying to push off the leg for distance because he thinks that by pushing off hard, he will cover more distance. The problem is that his foot stays on the ground for too long. A child should run with a very quick lift of the foot. 

How to correct it? 

Teach your child to run with a quick lift of the foot, so as soon as the forefoot touches the ground, the heels will lift up towards the hips. The foot will swing forward and touch the ground directly under the hips.

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