Do People with Down Syndrome Need Orthotics?

Anyone familiar with Down syndrome and its early symptoms knows that one of the first signs a doctor can tell a child may have Down syndrome is often spotted in the first trimester of gestation. 

Through ultrasound, a technician will look at the hands for something called a “Palmer crease,” also known as a “simian crease,” and look at the feet for a deep plantar crease and a broad space between the first and second toes. Sometimes webbing between the 2nd and 3rd toes is also noted this early.

With that said, as people with Down syndrome grow older, many foot conditions can become prominent, including but not limited to flatfoot, bunions, and secondary problems due to Joint Hypermobility. All of these conditions can be extremely painful, and treating the symptoms early is best.

Down syndrome is a common genetic disorder that occurs when extra genetic material is found in chromosome 21, resulting in an additional or partial chromosome. Some physical characteristics generally indicative of Down syndrome are upturned almond-shaped eyes, eyes with white specks in them, a short wide neck, a flattened face with a “button nose,” small ears, and straight, connected lines in the hands and feet.

It is a little-known fact that people with Down syndrome physically age faster than the average person, meaning they will deal with some painful conditions much sooner than others.

Some people with Down syndrome experience arthritis in their childhood, and several children have problems with their back and their feet. Fortunately, there are treatment options available to help soothe, correct, and even prevent some of these foot pain issues.

Hallux varus is characterized by the big toe leaning away from the other toes, causing a gap between the toes, and is one of the first markers of Down syndrome. The wide gap between the big toe and the second toe is not always indicative of Down syndrome, however, and can be caused by several other conditions, or can be developed. When the situation is developed, it is also referred to as a “Sandal Gap.”

Hallux varus can be very painful throughout the foot, and some patients require corrective surgery, however, one common non-invasive treatment for those with milder hallux varus to consider is custom orthotics.

Syndactyly of the feet, also known as “webbed feet” are not typically painful, but having webbed feet can make finding well-fitting shoes difficult. Wearing shoes that do not fit correctly can lead to many other issues, including other foot conditions, and back issues.

Unfortunately, people with down syndrome often walk around in ill-fitting shoes due to the unique shape of their feet, which can have painful repercussions. Companies like Bilt Labs, who manufacture custom orthotics, are looking to change that reality and make it easier for everyone to walk comfortably, no matter the foot conditions accounted for in making of their orthotics.

Another foot problem many people with Down syndrome could suffer from is bunions. Bunions, otherwise known as hallux valgus, have the opposite effect than that of hallux varus. The big toe will instead lean toward the other toes, resulting in a “bump” at the base of your big toe. There are many causes of bunions including:

• Shoes being too tight or wearing heels too often.
• Shoes generally not fit correctly.
• Inflammatory conditions, such as rheumatoid arthritis.
• Conditions that cause Joint Hypermobility syndrome.

Custom orthotics can be designed to realign the toes, and manufacturers will add an indention for added space. This makes the foot fit better in the shoe and maximizes comfort during everyday activities.

When the protein collagen is weak, sometimes due to an autoimmune disorder, it causes Joint Hypermobility. The resulting stretchy, loose skin and ligaments allow the joints to be easily manipulated and are often called “double-jointed.”

Joint Hypermobility is also a common characteristic of Ehler’s Danlos Syndrome and often leads to the development of arthritis. It is one of the leading causes of chronic pain, yet it usually goes undiagnosed and untreated.

The condition can also cause several secondary issues, such as metatarsalgia, and each presents a new set of problems. Although one might think there could be some benefits of increased flexibility, it does put individuals at a higher risk for injury, such as joints being easily dislocated or spraining.