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My eldest (11) out toes when he runs. This results in him having a strange gait (slamming feet down), and he also suffers from quite a few ankle injuries when playing football. (Physios have given him stretches to improve this).
Doctor thinks 'he will grow out it', the physio wasn't sure that he would. Wondered if anyone else's kids had this and if they grew out of it?
Is there any value in getting him seen by a private physio, specialising in running etc. (I don't want to just wait for him to grow out of it if its going to cause him problems in future)
I had this all my life, only realised when I went to a running coach in my 30s and he filmed me running. Was [I]very[/I] obvious on the video & yes affected my walking/running etc.
Managed to train myself out of it within a couple of months simply by paying attention when walking (& walking as much as possible!) & running and deliberately focusing on keeping everything in alignment. Was honestly very surprised how easy it was, been fine ever since.
I don't think it's something you'd "grow out of" (certainly I didn't) and afterwards, being conscious of it, I made a point of observing how other people walk/run - a lot of people (most, maybe) do it to some extent.
If you were going to pay to see a private physio, rather than going to an expert running physio, invest in seeing a paediatric physio. It may be that your boy is hypermobile and could do with some strengthening....
There are a few private paeds physios around, but you will want to check they have decent MSK or rheumatology experience and not be neuro experts (many private paeds physios are more tailored towards neuro-disability).
My lass intoes. Numerous NHS apps, little improvement. Private physio basically gave her yoga conditioning and made her aware of her posture and gait and tips to improve it. Glad I paid for it as she now believes what I've been saying all along 😀 Hypermobile as F (good for the contortion classes at Circus School!) so good to know which bit to focus on strengthening
Thanks for the help. Ok, will have a bit of a Google and see if there are any paeds physios local.
With regards to training him out of it, I'm not sure its habit, more the way his ankle is formed/working. If he is asked to walk/run with his foot straight he struggles. He doesn't seem to have the flexibility in his ankle to flex his toes towards/away from his knee. (hence the ankle injuries seem to happen in football when stretching into a tackle/clearance)
When we run together I challenge him to try and run quietly rather than slamming his feet down. However trying to persuade a super competitive kid to slow down in order to improve form and then eventually speed is a challenge!
If you were going to pay to see a private physio, rather than going to an expert running physio, invest in seeing a paediatric physio. Thanks
No disrespect to Physios but You would be better investing in getting an opinion of an Orthopaedic Consultant if you think it’s an issue. I can recommend a good one in Yorkshire.
<No disrespect to Physios but You would be better investing in getting an opinion of an Orthopaedic Consultant if you think it’s an issue.>
Horses for courses really, orthopods certainly have their areas of expertise, but for a first look i wouldn't think they would be the first port of call. You would want a more generalist (paediatrician with orthopaedic/ MSK and rheumatology experience), rather than any old orthopaedic surgeon. Children and adults are very different...
In my opinion, paeds physios are cheaper and would typically point you in the right direction if needed...
(- I was a physio and so may be biased. My wife is a paeds physio and works with lots of highly specialised medics, i doubt any of whom see adults)
+1 for seeing a consultant, I mildly out toe due to external tibial rotation and no amount of physio will ever solve that and attempts to correct the out-toeing from a muscular point of view caused severe knee pain.
rather than any old orthopaedic surgeon
No one is suggesting going to see any old ortho surgeon, they do specialise.
Why pay twice? Get a review from the top of the tree and work down rather than risk miss diagnosis or pay twice. A private consultation should be approx £150-£250. If the consultant determines its not a bone/skeletal issue then crack on with physio
The NHS is strapped for cash. Any Orthopaedic issues are not routinely put through straight away (including physio).
Our gp referred our son to outpatient orthotist appointment for rolling in/flat feet secondary to joint laxity. He has 6 monthly checks and wears orthotic foot beds. Referral was pretty straightforward, what does your gap think?
SO I probably should have been clearer. He did see a orthopaedic consultant following a referral from our GP. Its him who has said he will grow out of it. That was about 6 months + ago, but there has not been much/any improvement, still a lack of flexibility with foot straight. (and in that 6 months he has had a number of sore ankles).
Basically im happy to pay to get a second opinion, just to make sure we are not ignoring a problem.
FunkyDunc; Is your recommendation south Yorkshire?
Nope it’s North Yorkshire based out of Harrogate.
I have no interest with this person other than my wife being an Orthopaedic Consultant (doesn’t do private) and she has suggested friends send kids to him for similar stuff in the past
<blockquoteNo one is suggesting going to see any old ortho surgeon, they do specialise.
Why pay twice? Get a review from the top of the tree and work down rather than risk miss diagnosis or pay twice. A private consultation should be approx £150-£250. If the consultant determines its not a bone/skeletal issue then crack on with physio>
I don't think i agree going to a consultant orthapod straight away is always the best approach... i've seen my fair share of patients that haven't been referred for physio after seeing an orthopaedic consultant for an issue they've had (where the evidence would suggest that conservative management and exercise are the best interventions). Also, there is quite a large body of evidence now suggesting some orthopaedic interventions are no better than conservative management (e.g. physio / osteo / chiro for knee OA, low back pain), and in some instances are no better than sham surgery.
I think ortho is great for some things, but conservative management approaches (ie. non-surgical management) are probably better to be explored first, and the people to do that would be the heathcare professionals who provide those interventions (whether that be a podiatrist / orthotist / physio). Or if you want to see a medic, i would look for one who has a decent amount of paediatric experience.
Marp - I don’t disagree with what you are saying. OP is talking about paying privately to see a specialist. The most cost effective way to do that in my opinion is with a good Consultant. A good private Consultant doesn’t always suggest surgical intervention, but they are best placed to know overall management
If this was NHS I wouldn’t be giving the same answer.