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coxa valga
I just started seeing a ?7 year old boy with bilateral congenital coxa valga. He walks with an increased lordosis, a slight circumductory gait and is flat footed throughout his gait (i.e. he doesn't roll over his foot) and even spins off the ball of his foot on the right at "toe-off" (abducts his foot). Most of his muscle tightness is on the right side with tight iliopsoas, hamstrings, plantar fascia and has increased tension along the sciatic nerve with a SLR. We have just started with stretching in clinic and at home. I'm wondering where to go with this kid. Would an orthotic or simply a cushioning running shoe to help him roll over his foot help??? Any thoughts would be welcome regarding this or other typical treatment that is used with these kids. Thanks!
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re: coxa valga
Dear Physio. The particular case is of Orthopedic concern, all the problems of this child like Lordosis, Flatfooted etc. are secondary to B/L Coxavalga ie compensatory mechanism as the flatfoot and loss of roll over of foot is due to abducted legs to compensate the profound waddling gait, Lordosis is to make center of gravity between the feet during walking. He must have deformity little more on right side as u described the condition.
The actual need is wedge osteotmy to treat valgus deformity. As much as Physio's. Concern Stretching is helpful, strengthening of Abdominals, Invertors of feet, and Adductors, Extensors of hip. U can incorporate a medial wedge as medial arch to feet in the shoes. Concentrate on the walking pattern to improve.