Dr. Allan Horowitz, published newspaper article, The Liberal, Copyright 1987

QUESTION: My three-year-old son has very bad flat feet. He also is knock-kneed. When he walks, his knees actually bang into each other and he seems to be walking on the inside of his feet. What should I do?

ANSWER: I would do nothing if I were you. What you describe is very common in a three year old child. So, what you describe is really one phenomenon. The fact that your child is knock-kneed (this is actually referred to as Genu Valgum) means that when he is standing, his upper legs are straight to the knees and then the lower legs point out or away from the mid-line.

Because of this, he will be standing on the inside of his feet which will mean he will appear to have a flattened arch. Being knock-kneed and having flat feet usually go hand-in-hand. (Try it yourself. Put your knees together and then try to spread your lower legs apart, keeping your knees touching. You should end up on the insides of your feet.)

Most children between the ages of two and seven show this combination of flat feet and Genu Valgum. Most of them grow out of it by the time they are eight or nine years old. If it persists past the age of 10, it would be wise to have the child checked over by the family doctor, who might in turn refer the child to a pediatric orthopedic specialist.

This doctor would recognize those cases which should be treated by casts, braces, surgery or exercises and those cases which are best left alone. The vast majority of these children will grow out of it or will have such minor remnants that it is considered insignificant.

There is one thing that you as a mother can do to help keep track of your child’s condition. With your childing standing with his knees together, take a tape measure and record the distance between your child’s ankles. (Normally, they should be touching.) Measure between the large ‘bumps’ on the inside of each ankle, and record this distance.

Every six months measure again. If the distance is remaining constant or getting smaller, then don’t worry. If the distance is getting greater then it is time to have the child checked by someone more qualified than yourself.

Take the figures you recorded to the doctor as he will find them useful. Here are some statistics for you: 50 per cent of all normal three year olds have one to two inches between the ankles when measured in the manner described; 25 per cent have more than two inches.

So as you can see, despite the desire for every child to be ‘normal’, there really is no such thing. Your son will most likely be ‘straight-legged’ by the time he is 10.

If his legs and feet don’t straighten out in the next seven years, have him checked by an expert. Even though these doctors are very busy, seven years is a bit too early to book an appointment, so stop worrying.

Allan Horowitz, D.C., is a chiropractor and writes this public service column. He will attempt to answer readers’ questions on a variety of topics including back pain, headaches, sports injuries, nutrition and preventive medicine.