On September 30th, 2017 the DeCaro Total Footcare Center joined up with the American College of Pediatric Foot & Ankle Specialists to sponsor the 2017 Western Massachusetts annual Down Syndrome Buddy walk. Over 800 attended the walk. ACFAP President Dr. Louis DeCaro was present to screen the participants for biomechanical issues associated with Down syndrome. “The combination of ligamentous laxity and low muscle tone in a majority of those diagnosed with Down syndrome contribute to a lifetime of orthopedic problems. Screening the feet as early as possible is imperative for successful prevention of these issues, “ said DeCaro. The Buddy Walk was established in 1995 by the national Down syndrome society to celebrate Down syndrome awareness month in October and to promote acceptance and inclusion of people with Down syndrome.
The Down Syndrome Patient
In a patient diagnosed with Down syndrome, there are a multitude of concerns which may be present involving the heart, digestive system, spine, eyes, intellect, joints and mobility. Individuals with Down syndrome typically have problems with collagen, which is the major protein that makes up ligaments, tendons, cartilage, bone, and the support structure of the skin. This creates significant laxity from the feet up, thus beginning at a young age the lifelong destruction of the kinetic chain. “Almost all of the conditions that affect the bones and joints of people with Down syndrome arise from the abnormal collagen found in Down syndrome.” The resulting effect in 88% of the Down syndrome population is hypotonia, with ligamentous laxity and/or hyper-mobility of the joints. The combination of this ligamentous laxity and low muscle tone contribute to orthopedic problems in people with Down syndrome.
Within the feet, the most common foot problems which can be found in the Down syndrome patient are “digital deformities, hallux abductovalgus, pes plano valgus, metatarsus primus adductus, hyper mobile 1st ray, brachymetatarsia, Haglunds’ deformity, syndactaly and Tailors bunion.” Genu valgus and subluxation and/or dislocation of the patella are another concern due to this condition. Hip and spinal issues are often seen as well.
Overall laxity of the feet has been reported in 88% of children with Down syndrome. This percentage is far higher than in those without, yet often their feet are ignored. The primary medical diagnosis seems to trump the importance of good foot health. They should not. All medical issues should be addressed.
Specifically the Feet
This “collapse” will impair normal external rotation of some long bones of the body, which leads to multiple postural changes. When physical therapy is called upon to strengthen the child, failure or delay of achieving a strong kinetic chain is inevitable. You can’t build on a poor foundation! Not only will the structure not support it, but due to poor foot alignment, the muscles during the exercises may not even fire.
For the complete article by Dr. DeCaro:
Click to access Down-Syndrome-A-Serious-Pediatric-Podiatric-Issue.pdf
http://decaropodiatry.com/
http://acfap.org/
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Name: Trevor Wilkes
John Wayne was famous for more than one reason but that swagger tops the list! Here at Nolaro24 we see it as less than a swagger and more of a classic toe out gait. The toe out gait occurs when an uncompensated rearfoot varus is coupled with a neutral forefoot alignment. The C Quad cannot pronate at the subtalar joint and compensates with external rotation of the hips. While we may never really know what John Wayne’s foot type was, we enjoy using that famous swagger to help people understand what our C Quad patient walks like.