The latest issue of The Foot journal reports that flat feet in children ages 3-6 years old has a highly statistically significant relationship with increased hip internal rotation. Of the 569 children studied, 16% had flat feet. One hundred percent of those children had increased hip internal rotation compared to zero of the children without flat feet.
Pediatric physical therapists work with many children for in-toeing when walking. Frequently the focus of treatment is muscle strengthening and stretching to correct for muscle imbalances. This study reminds us to always check the feet as well. Both the feet and the hips need to be addressed when working with children who have increased hip internal rotation.
Reference: George Zafiropoulosa, Kodali Siva R.K. Prasada, Thomai Koubourab and George Danis (2008) Flat foot and femoral anteversion in children—A prospective study The Foot Volume 19, Issue 1, March 2009, Pages 50-54 doi:10.1016/j.foot.2008.09.003
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