Why we look at the feet first when your child's body seems to lean to one side

What follows combines several patients' visits into one composite story. It is not about any one child, and anything that could identify someone has been removed.

How do children usually come to us?

Parents tell us that in a photo, one of their child's shoulders looks higher and the back looks rounded. They come in about posture, but when we ask, the feet come up.

They also mention that the child doesn't like walking for long, often asks to be carried, and wears down the soles of the shoes on one side only.

Why look at the feet first, not the shoulders?

When the base is unsteady, the parts above take over the load. If the foot's base has collapsed, the knees and pelvis shift one after another, and at the end of that chain the shoulders and back tilt.

That's why, even if you just press the shoulders straight, they go back within a few days. Only the top was worked on, while the foundation was left as it was.

What do we look at?

We have the child stand barefoot and look from behind. We check how much of the hollow on the inner sole is left, whether the knees turn inward, and whether weight is even between left and right.

The hollow of the sole is called the arch.

We look at the upper body too. We check whether the shoulders are at different heights, whether the shoulder blades stick out from the back, and whether the back is rounded. Then we have the child stand on one foot — how much they wobble gives us a sense of their core strength.

How do we treat it?

We work from the bottom up. We build the foundation with custom insoles that support the arch, and then work on the position of the shoulders and back with Chuna (Korean manual therapy).

Then we build the strength to hold that position. We do exercises to strengthen the core and the muscles around the shoulder blades. If you only add support and leave the muscles as they are, the change won't last.

If the child is worn out, we support them with herbal medicine, because correcting posture also takes energy.

How did things go?

First, the spot where weight lands during walking changes. The child is less reluctant to walk for long, and posture changes more slowly than that.

Parents usually notice it first in photos. Many tell us the shoulders look more level than before.

What are the limits of this approach?

We don't tell you how much height your child will gain by straightening their posture. Nor do we tell you how much taller they will grow with this treatment.

Part of a child's arch forms as they grow, so not every foot that looks flat in early childhood needs treatment. If your child is in pain, if one side is unusually different, or if their walk suddenly changes, see an orthopedic doctor first.

To parents with the same worry

1. When the base is unsteady, the parts above take over — that's why we start with the feet.
2. If you only straighten the shoulders, the foundation stays the same, and they go back.
3. We have the child stand barefoot, look from behind, and have them stand on one foot.
4. If you only add support and leave the muscles as they are, the change won't last.
5. Not every foot that looks flat in early childhood needs treatment.

We look at the whole chain, from the feet up through the knees and lower back. If you only treat the spot that hurts, it comes back a few days later.

If your first steps in the morning hurt, or nothing changes even after switching shoes, come see us once. We don't look only at the feet; we follow the chain up through the knees and lower back.

There are many possible causes, so the same treatment can lead to different courses for each child.