Feet In Down Syndrome

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 too. 

Common Feet Issues For Those With Down Syndrome

Foot issues in Down syndrome falls under three primary categories:

Foot deformities

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

Shoe fitting issues

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.

Skin issues

Common skin issues include calluses and corns, excessive moisture between the toes that leads to skin damage, excessive dryness, toenail thickening, ingrown toenails and fungal nail infections.

Additionally, due to decreased muscle tone (hypotonia), the feet and legs can feel tired and achy at the end of the day.

How Is Gait Impacted By Down Syndrome?

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.

Treatment For Feet In Those With Down Syndrome

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:

  • Regular skin and nail care appointments: as the presence of corns, calluses and thickened toenails can produce much pain and discomfort, we regularly reduce the thickness of the nails, debride the callus, and remove corns. We’ll then look at what may be contributing to their development or quick progression, and put preventative measures in place, too.
  • Footwear modifications, custom footwear and shoe recommendations: we’re proud to offer a wide range of intuitive shoe modifications options to best accommodate your current symptoms and greatly improve your comfort in your existing shoes. We can create custom footwear options, as well as make recommendations for the best wider-based and supportive shoes on the current market for those with mild foot changes.
  • Custom foot orthotics: our custom foot orthotics are prescribed and designed uniquely for your feet following a detailed assessment and 3D foot scan. As such, they have very specific functions - whether that is to support or offload - as chosen by our podiatrists based on the current problems you’re experiencing. This may look like offloading a painful area, adding extra ankle support, and much more. Foot orthotics replace the liner of your shoe, and keep you supported and walking with maximum comfort with every step. As we prescribe every aspect of the orthotic, we also opt for lighter orthotic materials that don’t drag the feet down, in light of the lower muscle tone.
  • Ankle-foot orthoses (AFO): in some cases, custom AFOs may be used in place of foot orthoses. These offer similar benefits, but also extend above the ankle to add greater stability, and account for a greater level of weakness.
  • Surestep SMO: the Surestep supramalleolar orthoses (SMO) is a revolutionary treatment for children with low muscle tone as a result of Down syndrome. Together with the right Surestep footwear, it sets children up for success and enables them to have a new level of mobility and independence. 
  • Injury management: as the foot in Down syndrome is at greater risk of overall injury, if problems arise, such as heel pain, these will be managed using our proven protocols, with adjustments to account for every person’s unique circumstances. 


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.




Monday 7:30am - 6:30pm
Tuesday 7:30am - 6:00pm
Wednesday 7:30am - 6:30pm
7:30am - 6:00pm
Saturday CLOSED

Ground Floor, 344 Queen Street,
Brisbane City QLD 4000



Monday 7:30am - 6:00pm
Tuesday 7:30am - 6:00pm
Wednesday 7:30am - 6:00pm
7:30am - 6:30pm
Friday 7:30am - 5:30pm
Saturday 7:30am - 4:30pm

Newmarket Village, 114/400 Newmarket Rd, Newmarket QLD 4051