Welcome to Foot Talk Fridays!
We’re going to discuss ‘knock knees’ and that’s when the child’s knees lean in together, called ‘Gene Valgum.’ When the child’s knees go away from each other it’s called ‘Genuverous’.
Gene Valgum is quite common especially if the feet lean in. If the feet lean in, the knees can internally rotate and the knees can begin to bend together causing an X appearance. Some children might have a straight leg and one knee that bends in and that’s what we call a ‘K leg’ because it looks like a letter K.
So what we want to do initially is we want to find out where the Gene Valgum comes from – is it coming from the hip? Is it coming from the knee? Is it coming from
the foot? Is it coming from the ankle? Once we discover where it’s coming from that will change the treatment plan.
Say for example, we need to get the knee to point out wards and the space to open, we’ll put something underneath the foot that tilts the foot to get the knee to externally rotate again, because normally with the feet straight we want the knees to point at eleven and one o’clock.
The perfect position of the knees is eleven and one o’clock, we don’t want straight ahead knees either, we also don’t want the knees to point to ten and two o’clock or nine and three o’clock, we just want eleven and one o’ clock with the feet straight.
The reason for that is when the feet are straight and the ankles are straight, the hips are set wider, so the knee does have to get 50% of a different angle from the ankle to the hip ratio, so eleven and one o’clock is perfect alignment.
We also have to look at leg length because ‘leg length discrepancy’ is normal with growing children. When one leg grows longer than the other the pelvis will tilt, and one knee will point to a different direction compared to the other.
We have to understand that’s normal for children, but if you notice your child has knees that are leaning in or bending in it’s very important to take them to the podiatrist, or the orthopaedic, of course your general practitioner, or your paediatrician just to get a full scope of assessment done.
But most commonly we use something underneath the feet to tilt the feet to get the knees to change direction which is why if your child has ‘Gene Valgum’ or ‘Genuverous’ you’ll be asked to come and see a podiatrist to get the foot and ankle sorted to help with that.
So, what we do with Gene Valgum is we would put something underneath the foot, and we would tilt the foot (and that’s what this tilt is). Depending on the severity of the Gene Valgum, it depends on how high this wedge is so it can be anything from five degrees up to forty-five degrees in the most severe cases.
Again, say for example it’s a child, we would put a tilted orthotic with how many degrees (this child has a twenty-seven-degree tilt on to theirs) for their Gene Valgum inside school shoes and it fits easily inside the school shoe, of course we always like it with a strap on the top. For boy’s school shoes’ most of the time it’s very easy because they look like sports shoes.
Going back to Gene Valgum, normally if the ankle leans in you can imagine the leg will come up like this and then bend up to the top as well. That’s why we put something underneath the foot that will tilt the foot straight.
I will show you what we mean, say the foot leans inward like this, we would put something tilted so that when a child stands on it they are tilted straight and that’s how we correct Gene Valgum in most cases.
Enjoy your Friday!
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