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In utero, a baby’s feet are squeezed into a C shape with the soles turned inward. Sometimes this shape lingers after birth. For those with an interest in Latin, this condition is called metatarsus adductus or, more commonly, “pigeon toes.” In the old days, foot specialists systematically braced these little feet. This is no longer a common practice, except in those rare occurrences where the deformation is very pronounced. For most kids, a daily ankle massage will help the foot achieve its normal position, though the adjustment may take many months.
There are whole continents—Africa and Asia, to name two—where flat feet are the norm, and they don’t seem to impair mobility among billions of people. Africa has consistently produced some of the finest distance runners in the world, and it seems silly to suggest that they’d run even faster with well-articulated arches. But that’s exactly the kind of pro-arch propaganda that was rampant thirty years ago, when specialists routinely prescribed supplements and special shoes.
As it turns out, all toddlers have flat feet. Later on in childhood, the arch forms, but some children still have almost no arch. That’s just the way it is: a matter of taste, perhaps, but not of medical importance.
When some children take their first steps, they occasionally do so on the tips of their toes. In the vast majority, this walk disappears after a couple of months, but it sometimes lasts well into childhood. Toe walkers point their feet as they walk, mostly out of habit resulting from an unusually high muscle tone in the calf. But if you ask a toe walker to put his feet flat on the floor, he can. If the condition persists after a few months of walking, consult your doctor to evaluate whether the heel muscle is abnormally tight. Anecdotally, toe walking is often found in children with “sensory integration,” high-IQ children who are especially sensitive to their environment [See: Sensory Integration].
Once your doctor has established that there’s nothing wrong with the foot’s anatomy, it becomes a matter of gently redirecting your child’s behavior. As with all habits, the laissez-faire approach is best (ignore it or at least pretend to). The more attention you pay, the more you reinforce the behavior. Braces are prescribed sometimes, but I don’t recommend them; they are inefficient and stigmatizing.
Most toe walkers will eventually walk on the soles of their feet, although it may take many years. Often, normal socializing is an incentive: In elementary school, the child will become self-conscious and try harder to lose the habit. In the rare instances where the condition lingers beyond the teen years, surgery can be performed to lengthen the Achilles tendon.