Orthotics Part 1

So let's start from the bottom, literally.

How do you think about supportive shoes, inserts, high tops, SMOs and AFOs? Let's even dive a little bit deeper and more specific into these a little bit.

Sure, I think what each option is capable of changing and whether that matches the child's presentation is the most important.

For example, if I have a toddler who has a mild foot instability and maybe some flexible pronation, but they have good angle control and range of motion, and they're functioning well, I don't necessarily want to immediately jump to an AFO.

Could a supportive shoe help this child? Could a shoe insert help this child? Maybe a high top shoe will provide enough stability for this child to make progress as intended to? Those are the questions that I think worth asking before jumping to an orthosis.

Even thinking too about educating families on what a supportive shoe is, like how do they learn what a good shoe is when they're at the store? Like I think about even how many times I kind of explained, you know, shoes with a little bit more control versus shoes with a little bit more flexibility.

And even in the whole world of all the shoes available, there's lots of different things like that that we'll see and that the families just need some education on.

With my early intervention experience, what I've experienced the most is the parents are usually clueless.

They are not told what is the right age to introduce shoes.

And there have been cases where some parents are like, oh, I think my doctor told me that I need my kid to be barefooted for them to be more strong.

And then some parents are like, oh, my doctor told me or my friend told me that my kid needs to be in shoes all the time.

i feel like a lot of parents are also confused about what is the right age to introduce shoes the kid is no longer standing the kid is not is not exploring on the foot so the parent sometimes does not even introduce the shoes until much later when the kid is ready to stand but what happens in those situations is those kids are not really ready for the weight that the shoes bring in and then there is a lot of conflict that happens with the child that oh this is a new sensation a new environment The balance is off sometimes.

The kid is so used to being the soft sole that a harder sole makes it so harder for them to stand up and move around that they don't want to move around for a little bit till they get used to the weight of the shoes.

So I've had so many parents coming up to me asking these questions where they're like, what shoes should I wear? Oh, what shoes should I buy? We also have had a lot of parents who are like, oh, these shoes look so cute.

Are they not good enough? And then some parents are like, do you think these shoes hurt my kid is that why my kid is crying and I feel like a lot of part of my job when prescribing a shoe or something that is more stable for the kid is counseling or explaining parents that hey this is the goal this is what I want to achieve and this is the reason why I want to give a shoe I want to give a shoe which is for mere soul or a flexible soul for this exact reason because this is not happening at this biomechanical level and I think what has helped me a lot is during my this journey is always taking a little video of the feet of the kid when they're walking or when they're moving around and then showing it to the parents slowing it down and showing the parents that hey this is the joint that's doing this that it's not supposed to do or this is how it's supposed to be and this is what I'm looking for and this is what I'm hoping the shoe would change and I think that has made a big difference in my clinical practice or my judgment that has helped a lot of kid progress but also brought a lot of peace to the parents.

Yeah.

I mean, anytime I think we can bring them into our decision making process and help them understand at a way that's appropriate for them.

Right.

We don't need to take them through PT school, but we can certainly slow a video down and show them what we're seeing and and bring them into that decision making process.

And listen, like I'm a parent, too.

I have two boys.

They love Crocs.

I hate Crocs.

But, you know, I try to hold firm boundaries as I'm like Crocs are fine when we're going to the pool or when we're doing things.

But when you're going to school and I know you have physical education class four days a week, like that's not the appropriate footwear for that.

So let's start from the bottom, literally.

How do you think about supportive shoes, inserts, high tops, SMOs and AFOs? Let's even dive a little bit deeper and more specific into these a little bit.

Sure, I think what each option is capable of changing and whether that matches the child's presentation is the most important.

For example, if I have a toddler who has a mild foot instability and maybe some flexible pronation, but they have good angle control and range of motion, and they're functioning well, I don't necessarily want to immediately jump to an AFO.

Could a supportive shoe help this child? Could a shoe insert help this child? Maybe a high top shoe will provide enough stability for this child to make progress as intended to? Those are the questions that I think worth asking before jumping to an orthosis.

Even thinking too about educating families on what a supportive shoe is, like how do they learn what a good shoe is when they're at the store? Like I think about even how many times I kind of explained, you know, shoes with a little bit more control versus shoes with a little bit more flexibility.

And even in the whole world of all the shoes available, there's lots of different things like that that we'll see and that the families just need some education on.

With my early intervention experience, what I've experienced the most is the parents are usually clueless.

They are not told what is the right age to introduce shoes.

And there have been cases where some parents are like, oh, I think my doctor told me that I need my kid to be barefooted for them to be more strong.

And then some parents are like, oh, my doctor told me or my friend told me that my kid needs to be in shoes all the time.

i feel like a lot of parents are also confused about what is the right age to introduce shoes the kid is no longer standing the kid is not is not exploring on the foot so the parent sometimes does not even introduce the shoes until much later when the kid is ready to stand but what happens in those situations is those kids are not really ready for the weight that the shoes bring in and then there is a lot of conflict that happens with the child that oh this is a new sensation a new environment The balance is off sometimes.

The kid is so used to being the soft sole that a harder sole makes it so harder for them to stand up and move around that they don't want to move around for a little bit till they get used to the weight of the shoes.

So I've had so many parents coming up to me asking these questions where they're like, what shoes should I wear? Oh, what shoes should I buy? We also have had a lot of parents who are like, oh, these shoes look so cute.

Are they not good enough? And then some parents are like, do you think these shoes hurt my kid is that why my kid is crying and I feel like a lot of part of my job when prescribing a shoe or something that is more stable for the kid is counseling or explaining parents that hey this is the goal this is what I want to achieve and this is the reason why I want to give a shoe I want to give a shoe which is for mere soul or a flexible soul for this exact reason because this is not happening at this biomechanical level and I think what has helped me a lot is during my this journey is always taking a little video of the feet of the kid when they're walking or when they're moving around and then showing it to the parents slowing it down and showing the parents that hey this is the joint that's doing this that it's not supposed to do or this is how it's supposed to be and this is what I'm looking for and this is what I'm hoping the shoe would change and I think that has made a big difference in my clinical practice or my judgment that has helped a lot of kid progress but also brought a lot of peace to the parents.

Yeah.

I mean, anytime I think we can bring them into our decision making process and help them understand at a way that's appropriate for them.

Right.

We don't need to take them through PT school, but we can certainly slow a video down and show them what we're seeing and and bring them into that decision making process.

And listen, like I'm a parent, too.

I have two boys.

They love Crocs.

I hate Crocs.

But, you know, I try to hold firm boundaries as I'm like Crocs are fine when we're going to the pool or when we're doing things.

But when you're going to school and I know you have physical education class four days a week, like that's not the appropriate footwear for that.