Over pronation and turned in feet?

Hi,
I asked a question about this a while ago and got great feedback but now DD is a tad older and walking I just wanted to get some info from other ladies whom have had the same experience..
DD has turned in feet to the point where she trips over her own feet and is constantly falling over, sometimes it's like she twists her ankles when she falls, and this occurs out of no where, it's like her ankles just fail..
When her feet are relaxed they are slightly tilted upwards and and turned inwards alot! It seems her feet can't be straight even if I try and straighten them they are quiet easy to turn, eg. If I have her right foot in my hand I can tilt it to face upwards and turn it inwards more than I can get it flat and straight if that makes sense??? :(
I have a referral to Dr David Little at westmead children's hospital in the orthopedic unit, but when I rang today they said the dr will review the referral and send me an appt. by mail.. Now the referral itself only says "over pronation of the feet and turned in, twists and falls sometimes"
Ok my issue is the letter doesn't sound like its a serious issue, maybe it's the mummy thing that is making me think they will not see the entire issue at hand and may delay the appt. but it doesn't seem to read the entire concern at hand. :wall:
So my question is: has anyone else had this occur? What did you do or what was done to help your little one?
Do you think I should seek another opinion from another GP? And hopefully get another referral?
Also has anyone used this specialist?
Sorry for the long winded post but I'm literally in knots about this :(
We didn't end up seeing the specialist last time due to along wind of family deaths and unforeseen circumstances.. I'm feeling very down for failing her and not seeing to this earlier so I am aware I have failed her...


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Hi Sparklez,

Please don't think that you've failed her : you are doing your best for her now.

I can't speak from the point of view of a mother,and I don't know westmead or the specialist in question, but can let you know what I think as a health professional (physio, albeit one who has not dealt with paediatric orthopaedics for many years!) I understand why you're concerned that the referral might not describe the issue thoroughly enough, but as someone who's been responsible for prioritising referrals (as a physio) I think that there is enough information there for your DD to be prioritised correctly. THB it may not be considered a very high priority referral - not that it isn't a really important problem, but that her condition, or the chance that she will respond to treament, will not worsen significantly if she is not seen immediately.

Having said that, the excessive turning inward, and the ability to turn her sole upward, that you are describing, sounds like she is over-supinating, not overpronating as is written on the referral! I don't think the Gp knew what she was talking about, but at the same time, the referral to a paediatric orthopod is still the right course of action, and I don't think that seeing another GP would help much.

I don't know if you have considered paying to see a specialist privately instead? You could always contact the secretary of a few different paed orthos who work privately in your area and finding out what the initial consultation and the wait for a private appointment would be. This might put your mind at rest while you wait for the public appointment to come up. You could also ask the unit what the possible range of waits are, depending on how the referral is prioritised. They may be able to tell you that (and I'm inventing these numbers - don't panic!) high priority is 1-2 weeks, medium is 6-20 weeks and low is over 20 weeks, or something like that, and it would help you to decide if it's worth going privately or not. Another alternative would be to find a private paediatric orthopaedic physio, and get some advice on special stretches or activities which might help in the meantime.

Pholi thank you for responding!
Well knowing you know what you're talking about puts me at rest a great deal!
Can you give me a little more information?
Yes, I have thought about contacting private orthopedic's just due to the fact I feel bad for leaving it so long ;(
Also the word you said, that you think it may be is there any sort of treatment? One side is more visible than the other (feet wise)
A friend of mine who works at the children's hospital in outpatients Sao tht the wait is extremely high atm, somewhere around 3 months! Due to all the breaks etc, but said that also depends on the amount of emergencies that flood in also..
Do you know any specialists in Sydney at all?
Thank you soooo much!! I really appreciate your response! Xox


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You're welcome, Sparklez.

I'm afraid as a Perth girl, I really don't know Sydney at all...

For consultants, go to the website of one of the phi that operate in Sydney and look up their list of providers. I find that the easiest way to find a current list of specialist! Hopefully other BBers will give you recommendations, too.

For physios, go to the APA (Australian Physiotherapy Association) website and do a search for paediatric physios. The clinic receptionist will be able to tell you which physio they suggest for an orthopaedic foot problem. A good physio will look not just at her feet, but also at the joints and muscles of her ankles, knees, hips and back, as well. For example, if the muscles that rotate her hips inward are tight, what you see is turned in feet. A physio should also be able to suggest if her condition warrants looking at by a consultant, or if s/he thinks physio alone might be enough.

In terms of treatment, as I said there are often stretches and exercise that you and DD can do to lessen the effect of the problem on her walking, and help her to continue to develop as normally as possible. Often they will teach you to encourage her to sit or stand in a certain way, and give you tips as you how to make it into a game, not an exercise that ends up feeling like torture! Depending on the structural cause of the problem (specific muscle weakness, bony structural changes, ligamentous laxity or tightness, generalised muscle tone issues, etc) it may also be appropriate to fit her with orthotics (inserts that go into her shoes), give her splints that she wears while sleeping at night, perform a small operation, or a combination of these. Or maybe just stick with physio!

I can't be any more specific than that, really, because of the limitations of describing a problem in words... but there is almost definitely treatments available that will help her!

Feel free to ask if you have any more questions, I will do my best.

My DD has really flat feet, and is a bit bow legged. It was causing balance issues, and she was falling and tripping over all the time. She also couldn't balance very well. I ended up taking her to my orthotist who also does kids (turns out she has this wierd tendon problem causing it), because I have flat feet, and he gave us off the shelf orthotics (which he customised for us in that 1 foot was a lot worse a needed a bigger angle the other). He said if I go down the paed physio route (which I did for my son for tight calves & toe walking), then I will end up spending a lot, when you can't really 'fix' the issue (and they only recommend surgery if the patient is in extreme pain and can't walk which doesn't apply here), where as the simple physics of using an orthotic to change the angle that she walks at has really solves the problem. Of course it is only solved when she is wearing them obviously, but it has been 2 months now and I've seen a 95% improvement (she also has muscle tone issues from something else which I think accounts for the other 5%). You could try looking for a orthotist just for a cvonsult in the mean time?

Thanks for replying ladies! I really appreciate it, Yael, do you know the name of the problem at all?
I've booked in for a private orthopedic names Dr Michael Bellemore at Westmead Children's Hosp. Which my sons pediatrician recommended since he is very high up at that Hosp.
I did take my daughter to my childhood GP who I've been seeing since I was a child and he said it looks like a case of mild club foot but he does also think there is something else wrong, he suggested club foot due to the fact that her feet are turned twisted up ways while sitting and relaxed and also seems some of her toes are also curling in the incorrect manner.. I have no idea what I should be looking for but he said it really does need to be looked at ASAP as it is causing quiet discomfort and issues during walking, he said the reason they maybe so turned in while walking could be due to the club foot or due to muscles are too tight in her legs an feet as her shins seem to be a little turned in also which he said that when a child's muscles are twisted and tense the bones tend to do the same??
I have an appt on the 7th of march the earliest I could get ATM, but hopefully we can get this sorted and in the right step to fix it
Pholi, he also said that the precious dr doesn't know what his talking about and really shoul t of given a diagnosis when he isn't specialized in the area, so I took great delight in re reading your responses.. But again he isn't also a specialist in this dept. but he did treat my cousins daughter for an extremely bad case of club foot which nearly required amputation o her newborns feet due to complications in the womb so I am some what assured that I can get this fixed for her...
Thank you both sooo much!! You have definitely made me more confident in the direction I'm traveling in this :) thank you!! Xox


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From your description, i was going to ask if they had suggested clubfoot. I was born with severe clubfeet, and looked into current treatments just in case my babies were born with them. If you are given a diagnosis of clubfoot look into a specialist who does the Ponsetti treatment- this is largely non-surgical and uses massage, physio, plastering and strapping. Much better long term treatment than surgery.

Sparkles, I'm so glad you've seen someone who could give you more information - you are definitely doing the right thing getting her seen!

Re your previous Dr's diagnosis - hah! I could tell more from an internet forum than he could looking at her in person!

I wish you the best of luck with this, and would love to find out how you go with the private ortho.

HotI thanks Hun, it's good to have some sort of answer but I guess the formal answer will come on the 7th!
I looked into the dr today on the net, and he uses the treatment you have mentioned! Which is good!! I seen what my cousins daughter went through and I remember that feeling of seeing such a little being in sooo much pain and operation after operation! :(
Pholi lol!!! Thanks hun! If it wasn't for you I would of just kept going with his answer, seems you listened to me more than he did face to face and he actually seen her and her issues..
I am actually excited about her appt. now just want to get her fixed up and happy! :) thank you ladies!!
HotI may I ask did any of your children end up with club feet? Or any other issues with the legs or feet??


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Hi,

I think I replied to your post about this awhile ago. To me, what you are describing sounds like tibial torsion- google it and see what you think.

I just wanted to say, the doctor probably put that on the referral rather than be more specific because specialists/surgeons can be stuffy about a measly 'ole GP diagnosing such a condition... IYGWIM.

Keep us posted with how it goes :)

Thanks Delphmoon!! I'm going to do it now! ;)
Yeah I guess so, just seemed that he didn't put that much thought into it but I definitely see what you mean :)


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my cousin had similar problems (but not clubfoot) and she had plasters and botox injections in the muscles and HEAPS of physio (right up until 6 or 7) and now is 9 and you couldnt tell she ever had a problem. shes in melb and her doc said often surgery is not the most effective treatment these days. FX this can be a relatively easy fix for your DD.

Well just an update, we went to see the specialist and it's turns out the dr was wrong ;( silly man!
The dr said she has severe bilateral internal tibia torsion, so it's abut like pigeon toed but alot worse I guess, he doesn't do anything to any of his patients till they are 2 so now we have to hopefully wait and see what happens, he said there is a chance they could turn but he doubts it due to how turned in her tibia's are.
The cause, her way of sitting in my womb, wow was a bit shocked but at least I know the cause and why but now we have to wait and see how to fix it ;(
Thanks guys for all your replies ;)


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I'm glad you finally got some answers!