Does My Child Have a Postural Deformity?

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Postural deformities are a common problem among children. In fact, many adults aches and pains are the long-term effects of poor posture or bad alignment that started in childhood. There are many reasons why this happens, including bad habits not broken in time, bad diets and a lack of regular physical activity. Diagnosing postural deformities at an early age makes treatment possible, which may prevent serious postural abnormalities.

What Can Cause a Postural Deformity?

There are many things that can cause a postural deformity, but a few can be corrected to prevent long-term effects if caught early enough.

Excessive Pronation

Normal pronation is the natural side-to-side movement of the foot as you walk or run. The foot rolls a bit inward with each step, and from the time your heel strikes the ground, your arch begins to flatten and cushion the shock.

Excessive pronation is when the outside of the foot comes off the ground and the heel tips to the outside more than 10 degrees. Keep an eye out for your child's feet not being straight with the rest of the leg or curving into a C shape. By the time your child turns seven, the heel gets more vertical and shouldn't tip at all.

If pronation is not supported in standing, it can lead to knee pain and plantar fasciitis later on. There are exercises a physical therapist can teach you and arch supports that can be added to your child's shoes to prevent excessive ligament stretch in the foot as your child grows.


Intoeing is when your child walks or runs and their feet turn inward instead of pointing straight ahead. It's also commonly referred to as being "pigeon-toed." Intoeing is often first noticed by parents when their baby begins walking, but children at various ages may start intoeing for different reasons.

Intoeing shouldn't be present in any stage of typical development and can be a result of in-utero positioning or an overactive pull of lower leg or hip musculature. In older children, it can be a result of continuous W-sitting or heel sitting with feet turned in. In general, you should change or correct your child's sitting position if you see them sitting in these positions.

With intoeing, the sooner your child can see a physical therapist, the less likely orthopedic surgery will be required at a later age. In children under two, depending on the severity of the position, a better foot alignment for gait might be possible with shoe inserts, stretching of tight muscles, and strengthening of weak muscles.

If your child is referred to a therapist between four and six years of age, gait plate orthotics or twister straps might be used depending on the orientation of the intoeing. After age six or seven, seeing a physical therapist is still recommended to determine the orientation and severity of the intoeing. However, if the intoeing is too severe, physical therapist techniques will be ineffective and referral to orthopedic surgery will be suggested.

Toe Walking

Toe walking, or when a person walks on the balls of their feet, is a fairly common condition among toddlers and small children. Most children will grow out of this phase when they become better at walking and balancing. With increased motor function through experience walking they will usually self-correct over time.

The longer your child toe walks, the harder it will be for them to walk normally again. Catching and correcting it early it will save a lot of pain later on. If your child is a skilled walker and is toe walking more than 50 percent of the time, you should consult a physical therapist for an evaluation.

Catching and Correcting Deformities

If you think your child might benefit from a physical therapy evaluation or would like more information, please visit AdventHealth Sports Med and Rehab. You can also bring your child in to our Pediatric Rehab program at the AdventHealth Sports Medicine facility for a postural deformity evaluation with no physician referral required. This family-centered program focuses on the unique needs of each child, empowering parents with skills and strategies necessary to support their child's physical, emotional, and spiritual health.

Postural deformities can be a challenge to overcome, but with our help and your determination, your child can start out on the right foot toward improved health and wellness.

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