Knuckle foot - no reason to be bent over

More or less every week, we are presented with children aged between one and a half and three years old whose parents are concerned that the child has a foot that is too bow-legged.

But the truth is that around 97 per cent of all children aged 18 months have a fallen arches when they stand up straight. This means that the foot does not have a proper arch, but is flat on the ground and bends slightly inwards. This is normal and does not usually cause any problems.

Parents can also check this themselves, at least if the child is old enough to stand on tiptoe. Then you can ask them to do so. And when the child stands like this, you can see that the foot straightens and an arch forms on the sole of the foot. Then everything is in balance.

This bent-slump position can easily last until primary school age and does not require therapy. You can encourage and support the development a little, for example by letting the children walk barefoot a lot in summer or by doing small exercises, such as grasping marbles with the toes.

But the important message is: if the child doesn't have a super abnormal gait pattern or complain of pain - and that's never really the case - then a fallen arches foot doesn't need to be treated or regularly checked. You can take a look at it as part of preventive care, but that's all you need.

It also doesn't need physiotherapy and it doesn't need insoles, as used to be the case. We now know that this is completely unnecessary.

So the basic rule is to relax. If someone is completely unsure or finds something very strange, of course you should still talk to them when you visit the paediatrician.