what shoes for ds1 (9)? and is this really gonna fix it??

[belcantavinissima]

ds1 who has AS was seen by consult. paed today just for a general assessment and i have been concerned about strength (or lack of!) in his ankles esp the left one, both feet tilt inwards at the ankle when he walks (in a v flatfooted flipper like manner i might add), so much so recently that the left ankle is almost touching the ground when he walks.
the paed looked at it and she has suggeted we just get him some new shoes to support his feet. i dont think this is really going to do anything as his feet/ankle will still be the same when he is not wearing his shoes but she is reluctant to send him for physio/occ therapy . not sure why, i think she wants to take it one step at a time (scuse the pun ) and that we should try the easiest things first. i am however concerned that this needs sorting quickly so they dont become worse as he is already in adult size 5 shoes!
where o where am i going to find shoes that are going to help him? i think orthopaedic shoes are going to be the best for him but i gues i need a nother assessment by them/rereferrals etc for that. is there any brands online or on the highstreet you miught recommend in the interim?

thanks in advance and hope that all made sense

DD1 (age 4) is in kickers. They're a stiffish lace-up boot that is available all year round and in some fairly funky colours in the kids' sizes. But they are "normal" shoes iyswim. They're a bit more expensive because alas they are a semi-designer brand. So I guess £45 at her age, can't say if that scales for a 9yo. We got ours from our local independant kids' shoe shop.

I have found that after nearly a year in kickers the overpronation (which is the technical term for this I believe, sounds like she has what your DS1 has) has improved even with the boots off: I guess the ligaments were stretched and recovered. But she has her boots on all the time - no question of taking them off indoors or going out in wellies or trainers. She gets up, kickers on. Kickers off, bath & bed.

Kickers are like this

Your issue is that if the kickers (or other similar shoes - anything which laces up the ankle and is stiffish will do I should think) don't work they will be looking to put orthotic insoles in the shoes to support the instep. Usually you do this by taking the insole out, but you can't take the insole out of kickers so the shoe will be too small for the "next step" so need to buy another pair of shoes. But at this stage they may be looking at specific orthapaedic brands anyway, piedros is the famous one. They are pricey but you may get this cost covered. We're currently at the stage where they have realised they can't get the orthotics in the kickers and so are talking to the orthotist about next steps.

Don't know if that helps?

thank you very much that is very helpful

I would definitely second Kickers, they have a really good instep and good support round the ankle. Dd3 has them while we wait for her piedros. If you want proper orthotics you do have to keep on at them a bit, most doctors have their budgets in mind when doing referrals. The other make of kids shoes with a good instep is startrite but may not offer enough support round the ankle. Keep on at the doctor and get the referral if that is what you think would be best for him.

i gave my sob kickers as an interim before piedros.

for a girl though you might want to try the patent ones as they are much stiffer
i was buying a new set of leather ones every month as my son would wear down the leather on the inside of his feet and it would be too soft and not supportive enough.

btw i have found a company that will sell piedros online without a prescription or letter from dr. although we didnt have to do this in the end as ds problems were so obvious. he had the same problem with muscle tone and hyperextensive joints and his ankle were lleaning inward.
in he end he was getting so tired walking and had such severe pain that the orthotist had no choice.

good luck
i will find a nd post the link to the company that sell piedros

www.aodmobility.com/Piedro_Shoes/piedro_shoes.html

they are not cheap and yes they are in canada, but i emailed them and they were really helpful and have them in stock to post to the uk.

Bloody hell - please dont get Piedros from Canada! can you self refer to a Podiatrist? Or an Orthotist? Either will look at your son's overall posture, and will consider an insole or adaptations to shoes, as well as suggest/provide footwear if neccessary.

At 9 your sone is probably getting too tall and heavy to get good support from off the peg footwear. A Paediatric Physio could give advice, but it would be better to see a physio with one of the above.

Sounds like your Paed is fobbing you off for some reason - if your son was a lot younger I would agree with waiting and seeing, but he is probably going to have a big growth spurt soon, and this will not go away, he needs support!

If you get no joy, NHS gets Piedros fron Gilbert and Mellish in UK, I will see if I can get any links.

Just checked G&M and they only supply on prescription.

When i used to work in London, some of the medical supplies stores in the West End used to sell them (Wigmore Street has a few).

Otherwise Kickers probably your best bet for stiffness.

What a pain! Why wont doctors refer to the professionals who can actually help, instead if dithering?

Sorry, rant over, not helpful!

no, its all helpful. i KNEW it was a problem, its just getting them to see it. ds says it doesnt hurt etc but what if it continues getting worse? he will actually be walking on his LEG soon fgs! how do i self- refer?

I think you should pursue this further. Have him checked by a rheumatologist for hypermobile joints. Have a podiatrist look at him. You want to know why he is walking like this.

If he is hypermobile, it may end up affecting other joints and even other parts of his body (bladder, bowels, skin) and you want to see a specialist. With dd it started with ankles, then went on to knees, hips, lower back, fingers and elbows. Though of course that was only the symptoms, the actual problem had been there all along. It just got to a point where her body couldn't cope with more overstraining from bad positioning of the joints. It is very common for pain symptoms to surface during prepuberty/puberty in hypermobile children.

You get your GP to do a referral to a specialist. Just tell him what you want. You may also want to check out the website of the Hypermobility Association to see if there is anything there that rings a bell.

Don't expect a general paeditrician to know much about specialist stuff, they don't. I have found dd's paed is good for writing the letters (to school, LEA etc) that I tell her to write but that I know more about dd's condition.

My DS4 wears Piedros as he has extensive hypermobilty. I have been looking for something more outdoorsy and possibly waterproof. Found Ostrich - which are made by Piedro - very pricey though.

meant to add this link

omg cory, i just googled hypermobility and it mentioned something called skin hyperextensibility- ds1 must deffo have that- he can pull his skin away from his torso- ugghh!. not sure about the hypermobility thing though.

however have decided to take him to the gp and get her to have a look/refer as can see its going to take ages with paed if she ever does anything at all.

I think it's mad that they've told you to buy "supportive" footwear, and have very much left you to it

My dd's 5, and her ankles sound similar to your son's. Seeing her ankles touching the ground makes me wince tbh. Because she has extensive hypermobility in all of her joints, she is under the orthopaedic surgeon. She referred dd to the surgical appliances/orthotics department to be fitted for Piedro boots. They come in a range of colours, styles depend on size and width.

The boots are free if you do it this way, but it can take ages to get an appointment and then ages again before you get the boots. I was told that I could buy additional pairs, but that they would cost approx. £100. They come from Gilbert and Mellish, but need to be properly fitted because they are so rigid I guess they could damage a child's feet if they weren't right!

It really is wrong that you were sent away to sort it out yourselves!
My ds is also under an orthopaedic surgeon for flat feet and hypermobile joints and as his aren't so bad it's solved by inserts into his shoes/ boots.
They really have helped and are easily transferred. I would def now go to the G.P for a referral.

am going to try and get appt with gp tomorrow before the long weekend and in the meantime i think i will try and get him some kicker boots to support it. had a chat with hiss school teacher today who sad apparently his gym club teacher has mentioned his odd gait tho apparently noone thought to mention anything to me . feel a bit crap that it has taken me so long to notice how bad its gotten

sorry for typos!

I agree that you need to see a specialist and get referred fro a proper fitting of orthopaedic footwear. Piedros come in a range of very attractive styles now. And it will be much better to get them free. Piedros come in a variety of specialist models, too - built for whichever way the foot tilts etc - and he may need inserts in the soles. DS wears Piedros with inserts to support one side of his foot.

Deepbreath - our orthotcs service told us, initially, that Ds could only have one pair of shoes supplied on the NHS. DS's physio was outraged, and i got her, and our GP, to write saying that it was essential for a child to have more than one pair of shoes to lead a normal life - one pair getting soaked in rain etc, having a 'best' pair and a scruffy pair, and they relented. Had they not, I would have written to my MP and everything. But then DS has different sized feet so every pair he has is made up of two pairs - so 4 pairs of expensive Piedros every time he has new shoes!

Put up a fight!

Blu, dd has had this pair of boots for 15 months... I've been fighting for a new pair for the last 7 months with no joy because they swore that there was still a tiny amount of growing room left, and they couldn't order more until she'd outgrown them!

Thankfully, dd is also getting insoles this time. These can be put into other boots if necessary. They might even help dd's feet to fill a D or E width in Clarks if we're lucky

Sorry for the hijack, belcantavinissima. I'm not trying to put anyone off, it's just that in some areas of the country the orthotics service is lacking in staff/funding.

Our orthotics dept started being mean and badly co-ordinated when it was 'outsourced' by the NHS Trust. I have found orthotics to be the only unsatisfactory part of DS's NHS treatment. I wroe an official complaint about a load of stuff. It's SO frustrating.