Ever since my daughter Audrey started walking, we noticed that her gait was a bit different. She was late to the walking game, starting around 15 months. And once she took off, we saw that she seemed to walk on the extreme insides of her feet, with her feet pointing outward, and with her little toes gripping the ground very hard. Her gait was extremely different from her twinbling sister, who walked in the more traditional pigeon-toed toddler style.
We asked our pediatrician about Audrey’s walking style at her 15-month well-check, but because she had only just started to walk, we decided together to wait a few weeks and see if it improved naturally. Still, we received a referral to a physical therapist at that same appointment and I kept the contact information handy.
Over the next few weeks, we bought Audrey some sturdy high-top shoes that we hoped would help stabilize her ankles. While this helped a bit, we remained concerned and so we reached out and made an appointment with the physical therapist. Audrey’s first PT appointment took place around her 17-month birthday.
The physical therapist finally gave us a word for Audrey’s different style of walking – overpronation. This basically means that the foot rolls in a little too much. She noticed that Audrey has pretty flat feet, and we learned that overpronation is often seen in flat footed kiddos. She also asked us several questions about Audrey’s physical and body movements, and we mentioned that Audrey’s first nickname was “Floppy” because she always seemed to flop around, ever since birth, with little control over her body and muscles. The PT gave us a better word for that as well – low muscle tone. She explained that overpronation and low muscle tone are often also seen together.
At that first visit, the PT suggested that we purchase some special foot orthotics for Audrey. Her recommendation was to start with the mildest orthotic, see how it went, and then reevaluate if we needed to increase the intensity a bit. She suggested that we order from a company called Cascade Dafo because it can be difficult to get the orthotic just right, and this company understands that aspect and so allows a 90-day return period.
We started Audrey with a pair of the “Cricket” inserts. These inserts fit inside most shoes, and our PT suggested high-top shoes be paired with these. We had a pair of See Kai Run high-top sneakers on hand, and the crickets fit well inside the shoes. We did a slow ramp-up of putting Audrey in the orthotics/shoes for increasing amounts of time each day, starting with 20-30 minutes in the morning and afternoon, and ramping up to her being in the orthotics/shoes for most of the day.
We were told that in the beginning, Audrey would be pretty unstable in the orthotics, and would look again like a “new walker.” That was spot on! Audrey stomped around a lot in her shoes, and she just generally seemed more floppy and unsteady than ever. While this eventually subsided a bit, we were a little disappointed that the orthotics just didn’t seem to be having a positive impact. Following a couple of follow-up sessions, our PT suggested that we go up to the next level of orthotic.
Upon her advice, we purchased a pair of the “Leap Frog” orthotics in early January. These are more intense than Audrey’s first pair of orthotics, and they go up to her ankle and have straps across her foot. Audrey is a very good-natured kiddo, and she didn’t really seem to bat an eye when we moved her up to this new style. Following another evaluation with our PT, we decided that Audrey should be in these more intense orthotics and we are in the process of returning the more mild pair. It’s only been a few weeks, but we’ve been encouraged that she has taken well to her new shoes/orthotics. Interestingly, when I take off her shoes/orthotics now at night, she wants to immediately put them back on so I think that she really likes the feeling of stability that the orthotics provide.
The biggest negative about going up to the more intense orthotic is that they are bulkier and don’t fit inside Audrey’s shoes as easily. Our PT suggested a pair of Nike Revolution 4 FlyEase shoes, which are really pretty cool in that they zip off at the heel, making it easier to fit in her orthotics. Still, while these are working great in the winter in Chicago, I’m worried that Audrey’s poor little feet will get really hot in the summer in these shoes and the bulky orthotics. I hope that I’ll come across something between now and then that will be a good solution!
While we think that we now have Audrey in the proper orthotic, we still keep a standing monthly appointment with her PT. She teaches us so many good exercises to help Audrey’s overpronation and her low muscle tone, and we’re happy to have someone guide us along to ensure that she gets the best support in her walking going forward.