Orthotics for Kids? Do they work?

Reference:Whitford D, Esterman A. A randomized controlled trial of two types of in-shoe orthoses in children with flexible excess pronation of the feet. Foot Ankle Int. 2007 Jun;28(6):715-23.

Millions of dollars per year are spent on foot orthotics for children with pes planus; however, there is little evidence that orthotics actually improve function or reduce pain.

In this study, 160 children between the ages of 7 and 11 years with bilateral flexible excess pronation based on calcaneal eversion and navicular drop were randomized into one of 3 groups:

i) No orthotics
ii) Custom-made orthotics
iii) Pre-fabricated soft orthotics

The outcomes evaluated included pain, gross motor proficiency, self-perception and exercise efficiency.

Basic Conclusion: This study found no evidence to justify the prescription of orthotics in children with excessive foot pronation as all three groups had similar outcomes after 3 months and 1 year.

Personal Comment: When I see a parent who is concerned about their child’s flat feet, my first advice is keep your child as active as possible. Second, have your child walk around barefoot as much as possible. Third, avoid the expensive supportive running shoes and stick to unsupportive, flexible flat shoes.

You want the child’s IFM to develop to their full potential without the restriction of artificial supports. After all, would you unnecessarily put a child in a back brace?

Addendum: Before you think I am orthotics bashing, I’m not. Customised foot orthotics can be very valuable in certain children with obvious foot deformities, arthritis, or those in pain and unresponsive to other conservative managements.

Posted on: March 10, 2014

Categories: Foot & Ankle

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