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‘The Benefits of Being Barefoot’

As you might expect, there’s a fair amount of debate out there as to the benefits of being barefoot as opposed to the protection of shoes and footwear. Parents of babies and young children often ask the Body Mechanix paediatric team for advice regarding footwear in the early years. Read on for the answers to questions like:

– When is the best time to buy shoes for my baby/toddler?
– What sort of shoe is best for my child?
– My child has flat feet, do I need to consider an arch support?
– Should my child wear shoes at all?

Some research suggests that wearing shoes is actually doing more harm than good and that delaying your child’s first pair of shoes or keeping them barefoot more often than not in their younger years is likely to be very beneficial.

To strengthen muscles, they need regular use under load. Implementing a firm shoe sole with high ankle support will reduce the amount of movement at the joints in the foot and ankle as they absorb the forces from the ground and terrain when walking. Reduced joint movement means the 4 layers of muscles in the foot and the lower limb muscles will not have to work as hard to stabilise. It’s easy to understand how shoes can hinder muscle development in the lower extremities and how within a short period of time, a child’s muscle development can be easily compromised comparably to a child who has spent more time out of shoes at a young age.

But it’s not just the strengthening of muscles which is affected as there’s less ability to stretch the toes, the arches of the feet and lengthen through the legs and hips too. Greater ability to stretch leads to improved overall flexibility, important for a healthy musculoskeletal system, especailly as we age.

Arches develop as the bones of the feet ossify, muscle tone increases, ligaments strengthen and gait is mastered. Transverse and longitudinal arches develop in the feet at around three years old, hence the difficulty to detect an arch in a baby/young toddler. Some doctors may tell you that children grow out of flat feet. Unfortunately, this is not always the case. Recognising and treating flat feet (pes planus) early will help an arch to develop, alleviate potential pain and prevent muscular and bony deformities. If your child’s arch hasn’t developed by the age of seven or eight, their flat feet might become permanent. Should your child look like they are struggling with their arch development or there is a history of flat-footedness in the family, it is a good idea to bring your child to the clinic for an appointment. Leaving flat feet untreated can result in many serious, potentially permanent foot and ankle problems including hammertoes, bunions, frequent ankle sprains and arthritis. You might also find your child starts avoiding sport and outdoor activities so it’s always a good idea to intervene early.

The feet have a huge influence in our sensory feedback and development. Appreciating different surfaces underfoot from carpet and tile to vinyl and grass at an early age will help children understand the need for balance and careful gait dependant on the surface of the terrain. It is argued that shoes can cloud the messages sent from the feet to the brain reducing this useful feedback of information.

Stretching our ligaments gives the brain feedback as to the range of movement available and where our joints are in space. This is known as proprioception. It is well understood that a strong proprioceptive foundation will pay dividends later in life, aiding balance and coordination; reducing the risk of trips, falls, and injuries in childhood.
An example of a loss of proprioception is often noticable after ankle ligament sprain. Those who have suffered such an injury will appreciate the reduction of stability and balance at the ankle for a number of months and potentially years should they not rehabilitate effectively, hence the importance of ligaments within our joints.

Children’s shoes play an important role in supporting their physical development and whilst there are many brands on the market, the top three which continue to stand out are Bobux, Geox and Clark’s. Whilst we appreciate peoples budgets will vary and shoes can be expensive, it’s important to remember, no other item of clothing has the same impact on a child’s growth or comfort. It’s well worth investing in the most reliable brand you can afford. Poor and ill-fitting shoes such as flip flops are often the cause of many accidents, trips and falls so it is important to remember this when considering the right type of footwear.

Babies, toddlers and young children’s bones have a higher collagen content than that of adult bones. As such their bones are more malleable and responsive to compression so it is important to have your child’s shoes fitted by a professional who can ensure there is enough room for appropriate structural foot, toe and toenail development without being squashed or compressed. It is also worth remembering the speed of which children’s feet grow and the importance of having children’s feet regularly measured.

Whilst there are many benefits of being barefoot, we can’t forget that there are some places where children probably should wear shoes, especially on hazardous terrain. On hot, cold, slippery and wet surfaces it’s a good idea for children to wear shoes to protect the soles and reduce the risk of slips. The same goes for walking in long grasses and unknown terrain as there may be some unexpected insects, parasites, snakes and critters that your child’s feet could come into. Certainly, some areas are safer than others when it comes to running about barefoot.

In conclusion, evidence suggests there is a significant benefit to encouraging children to spent as much time out of shoes as possible, especially in the house and safer terrain, but continuing to recognising the importance of good quality, sensible footwear as and when required.

To provide first class treatments, our paediatric Osteopaths have additional postgraduate qualifications from the prestigious Osteopathic Centre for Children. The clinical team is led by lead Osteopath Claire Mckenna who has been practising in the complex field of paediatrics since 2012. Should you have any concerns regarding your child’s foot, ankle and lower limb development, feel free to book an appointment.

Shoulder pain?

Suffering from a shoulder problem? Why is it being so persistent? No one has given you a firm diagnosis?

The shoulder is an intricate joint and relies on muscles for its stability as opposed to the anatomical shape of the joint, primarily due to its shallow socket. What connects the shoulder with the upper body is solely ONE bone, that being the collar bone (clavicle)! Bearing this in mind, you can imagine that should the shoulder or clavicle suffer any damage, this can quickly lead to problems. The body’s most reliable way of informing you of a problem is through pain or discomfort… and so the cycle begins!

The most common injury to the shoulder is a ‘rotator cuff dysfunction’. The rotator cuff consists of 4 muscles that wrap around the ball and socket joint acting as stabilisers. Depending on your day to day activities; a forceful throw, lifting weights in a certain manner, pulling an object or a fall to the shoulder can cause damage to this muscle group.

Frustratingly shoulders do take a bit longer to heal than the average joint due to the soft tissues such as muscles, ligaments and the capsule which all merge together creating a knock-on effect as part of the healing process.

As your body is attempting recovery, it is normal for other areas around the shoulder as well as the upper neck and back to compensate. An injured shoulder becomes a heavy shoulder, so you can imagine it has a tendency to drag the neck and back with it.

In order to aid recovery, it is vital to address not only the shoulder joint and the rotator cuff muscles but equally the surrounding areas.
Do get your shoulder symptoms seen and don’t leave it too late, as the support system becomes vulnerable as it is only attached to the collar bone!

We hope this blog goes some way to explain why the whole-body mechanics become altered, the need for early intervention and osteopathic treatment.

Written by Gurkartar Raja, Osteopath, Senior Associate.

The Young Athlete

What would you rather your child learn to drive in? A Ford Fiesta or a Ferrari?

You’d say let them scratch the alloys and take a few corners too tight in the low powered Fiesta where the cost of a mistake is relatively low compared to a Ferrari where speed, power and price is far greater.

The same can be said for a young athlete. You want to make sure they’re getting mistakes out of their system when they’re not strong or powerful enough to hurt themselves. After all you rarely hear of a youngster tearing an ACL or hamstring, they’re simply not strong or powerful enough to do that… yet.

Too often coaches train a child for their sport rather than for life. We must ensure first and foremost children learn to move like a human, then move like an athlete, then move like a sport specialised athlete.

This is why between the ages of 2-12, mastering Fundamental Movement Skills (FMS) are paramount and provide the building blocks for confident and competent movement at an early age, that will act as the foundations from which more advanced skills can be developed throughout their athletic career.

Coaches and parents alike must recognise if your child can’t push, pull, bend, twist, squat, lunge, brace they’ve got no business running, jumping, landing, catching and if they can’t do these general movement patterns then they’ve got no business trying to build sports specific skill on top of that let, alone in a competitive environment. It’s like building a house on sand!

Children’s bodies are incredibly adaptable and learn to compensate for poor skill technique easily. Sometimes this will result in a minor injury or could become masked all together. The problem here arises when your child enters an age where they are ready to develop the physical qualities (12yrs- onwards) of strength and power, where the risk of injury and the cost of inefficient movement goes up.

So, if we want create physically literate children; developing FMSs around play in an unstructured manner is key. Think hop-scotch to develop sidestepping skills for example. The starting point is to introduce and teach isolated movements that help to master simple skills. Long term, aim to teach children to link movements and combine multiple skills for example, leaping links to catching, rotation and throwing in netballers. Which will then in turn lead proficient development of their sport-specific skills, like striking or tackling.

We mustn’t forget the benefits of strength training for children. When coached correctly, a strength development programme can reduce the risk of sports-related injuries as well as enhancing performance across most fitness components (plyometrics, endurance, agility, muscular power, running speed).

An effective and safe strength programme will focus on body weight exercises that reinforce FMSs, resistance band training and other low-level strength exercises/modalities. All exercises need to be of a level where the child can perform a minimum of 10-15 reps with fatigue but not muscle failure. After adolescence, increases in muscle mass as a result of increasing sex hormone concentrations will aid hypertrophy and performance in power exercises. This is where we need to be confident our child can safely drive their low power Fiesta before learning to drive a Ferrari.

If your child is struggling with injuries, seems limited in their mobility or struggles physically with their gross motor movements, maybe consider a trip to visit a paediatric Osteopath.

Here at Body Mechanix, a number of our Osteopaths have undertaken an extra 2 years of specialist paediatric training to enable professional and sound treatment of babies, young children and adolescents. So with that in mind, whether you bring a precious new-born or a strapping young adolescent, your children are in safe hands!!

Back Pain in Children

Like adults, children can also suffer from back pain as a result of a variety of different lifestyle activities; and like adults, there are a number of things that parents and carers can do to prevent issues arising.

If your child complains of back pain it is important to seek advice from a qualified paediatric professional. Osteopaths at Body Mechanix are highly experienced in the treatment of newborns to teenagers; so rest assured your osteopath is well equipped to treat or appropriately refer your child if required.

Good School Bags
Children are often required to carry bags full of books, PE kits, musical instruments and other equipment to and from school. Parents should try to limit the weight of school bags as much as possible and invest in a good quality back-pack that the child should wear across both shoulders, ideally with a strap across the chest to keep the load close to their body. Packing the bag with the heaviest items (such as laptops and heavy books) closest to the child’s body will also make carrying more comfortable and less likely to strain the muscles of the back.

Limit screen time
Looking down to use smart phones, tablets and laptops for an extended period can pull the back and neck into an unnatural posture, resulting in pain. Placing limits on the time spent using devices and encouraging regular breaks may help to avoid problems. If your child has to use a laptop for homework, consider purchasing a support that elevates the screen to a height that allows him or her to sit up straight to look at it.

Regular exercise
A sedentary lifestyle is known to contribute to the risk of developing back pain, as well as contributing to obesity. Regular physical activity helps to keep the core muscles that support the spine strong and maintain flexibility, which will help to avoid back pain. Encourage lots of active play, walking, running, swimming, cycling to keep your child fit and healthy.

Your child’s back pain may benefit from osteopathic treatment. Using gentle osteopathic techniques, it is possible to resolve the stresses and strains affecting the child’s developing bodies and relieve them of pain and discomfort. We can will also offer lifestyle advice to prevent the symptoms from returning! Feel free to get in touch for advice or more information surrounding paediatric back pain.