Down syndrome is a genetic condition caused by having an extra copy of their chromosome 21. While Down syndrome is often known for common
yet variable physical characteristics like a smaller stature, an upwards slant to the eyes, lower muscle tone and a single crease across
their palms, what many people don’t realise is that there are a range of foot problems that can occur in people with Down syndrome
Foot issues in Down syndrome falls under three primary categories:
Deformities often affect the forefoot, and may include a wider forefoot and bunions that progressively worsen over time, claw toes and hammer toes, webbing between the second and third toes, a greater space between the first and second toes, greater ligament laxity, and a flat foot posture that can then lead to additional problems like plantar fasciitis heel pain and knee pain.
Due to the nature of the wider and flatter foot, finding shoes that fit adequately can be a big challenge. One study found that when examining 48 children and adolescents with Down syndrome, 62% wore shoes that were too long and 60% wore shoes that were too narrow. Unfortunately, ill-fitting footwear is a big cause of foot pain, skin irritations, and can speed up the progression of foot deformities.
Additionally, due to decreased muscle tone (hypotonia), the feet and legs can feel tired and achy at the end of the day.
The gait in Down syndrome patients includes a number of challenges, and not just from the foot posture and low muscle tone. Other features that affect gait include reduced ankle range of motion, excessive hip flexion as well as rotation that points the toes outwards, and a tendency to walk on the toes. Ultimately, this can lead to poorer balance and a greater likelihood of tripping and falling from scuffing the feet along the ground when walking.
The way that our Brisbane podiatrists care for the feet of those with Down syndrome is by managing the symptoms and introducing preventative measures to help reduce the risk of pains, problems and falls.
To determine the best course of action, we complete a comprehensive assessment of the feet and legs, and get to know you, what you struggle with in daily life, and what your goals are. From there, we create a strategically tailored treatment plan that may involve:
Do you work with young children that have Down syndrome?
Absolutely. We work with all age ranges for our podiatry services and ensure that the treatment approach is in line with the evidence and practicality for that age range.
Is foot surgery recommended for people with Down syndrome?
Irrespective of the presence of Down syndrome, surgery for the management of changes to the feet like severe bunions, toe deformities and ankle problems is almost never considered a first line treatment. This is as alternative methods of care that are safe, non-invasive and do not pose a risk of infection or other complications are found to be effective and sufficient for most. If the unique nature of your feet mean that surgery should be seriously considered in the initial consultation, we’ll refer you to a trusted orthopaedic surgeon.
Are you a registered NDIS provider?
Absolutely. Under NDIS we can offer you a range of devices such as custom foot orthotics, AFOs and custom braces under the assistive technology support. For many people, this greatly improves their mobility, independence and quality of life.