Back-to-school time is a great opportunity to use your chiropractic expertise and healing care to help young patients prepare for the wide range of sports activities and physical demands that the new school year will bring.

Sports Physicals

In many school districts, chiropractors can perform sports physicals to allow children and teens to play specific sports.* Spread the word in your community that you are available for this service. It’s an effective way to expand the care you offer to all members of the family.

Before your young patients come in, check with the schools they attend as each district tends to have a specific “sports physical” form to fill out and sign.

When you have a parent and child in your exam room, stick with the protocols you’ve developed for every chiropractic patient. Perform your exam and spinal analysis, making sure you hit all of the check marks on the sports physical form. Be sure to include foot assessment as part of this plan. 

Remind children and their parents that regular chiropractic visits and Foot Levelers custom three arch orthotics are an important part of helping young athletes maintain healthy biomechanics so that they can achieve peak performance and lower their risk for injury. This is especially needed when they are involved in multiple sports and play all year round.

*The states that allow chiropractors to perform sports physicals vary. Check with your state chiropractic association to see if this is permitted in the location where you practice.  

The Impact of Dysfunctional Feet

 If someone is overpronating at any age, biomechanical stress and wear and tear will follow. Flattened arches will cause:

  • Feet to drop to the floor (medial ankle stress)
  • Inward rotation of the tibia and femur (medial knee and lateral hip stress)
  • Pelvic tilt and resultant functional scoliosis of the lumbar spine towards the side of the flatter foot.
  • Opposite side functional scoliosis of the thoracic spine
  • Uneven shoulders aiding in stress to the upper extremity
  • Neck and TMJ stress

Children can present with conditions like Sever’s Disease, sprained ankles, Achilles tendonitis, shin splints, Osgood Schlatter, ACL, patellofemoral tracking disorders, iliotibial band syndrome, hip, SI joint, and lower back pain. These all are related to the stability of the three arches that comprise the plantar vault and the lack of proper support that most footwear for children and young adults provides.

Why Kids need Custom Orthotic Stabilization

Arch dysfunction can begin at a young age. These issues can affect kinetic chain function and the effectiveness of chiropractic care if not addressed. Prescribing custom orthotics for young patients is a golden opportunity to not only address any existing pain but to also make lasting changes in their future. The younger we start, the more potential impact we can have. Foot Levelers are the only orthotics that support all three arches, balancing and aligning the entire body from the feet up, which is especially important as the body is growing and developing.

Many adults believe that if a human is young, their support and stability is fine and the physical stresses and injuries that later life brings have not yet affected them. Let’s dispel that faulty logic with respect to biomechanical and physical stress on the bodies of children.

There are many slip-on and laced shoes that are popular with this age group, but when you show parents how little arch support they actually have, it helps them understand why proper three arch support is necessary.

Even high-priced athletic shoes have a very flat insole that offers little to no arch support. Offer suggestions on how the kids can use custom orthotics in shoes that are stylish and comfortable. There might have to be some compromise, but there is a way to make the custom orthotic-shoe combination work out.

Key Talking Points for Introducing Custom Orthotics for Children and Teens:

  • Have the young patient stand in front of you and point out how their feet are functioning, showing them the effect it has on their ankles, leg, knee, thigh, hips, and pelvis. This helps them see how one or more body parts are getting stressed and why there could be pain.
  • Perform a foot assessment using a casting kit or Foot Levelers digital foot scanner. You can use the detailed Report of Findings generated by the scanner to share images and additional information for further clarity.
  • Since one or both parents will be present in the room with their child, this is your chance to educate them on the three arches of the feet and their effects on the ankles, knees, hips, pelvis, and spine. Since a major contributing factor to excessive foot pronation is genetics, one or both of the parents most likely will have foot dysfunction too. Have the parents take their shoes off as well so you can point their arches out to them and show the child where their flat feet are coming from. Depending on the age of the patient, you may be talking to the parents more than the child.
  • Many times the parent will help you convey the message about foot dysfunction because they know how to talk to their own child. Let the parents help you out if you get stuck in your explanation.

Have visual aids available like a skeletal model of a foot, custom orthotic samples, pictures of the three arches, and the Crooked Person diagram. Children are tactile and visual so those aids will help you get your message across to them.

Utilize The Ultra Young Sole: Ages 5-15

Ultra Young Soles® are an Ultra Active Orthotic made a little longer for the child’s foot to accommodate some foot growth in length. When the spine and pelvis are properly supported and balanced, children are more likely to develop optimal posture as they grow and lower the risk for degenerative changes in the knees, hips and spine in adulthood.

Ultra Young Sole orthotics are backed by the Foot Levelers Posture Protect Program. If the child’s  foot size increases 1 ½ sizes within a year (a new scan is required to ensure proper fit) parents can save money on new pairs.

CPOYA (Concerned Parents of Young Athletes): Ages 13-18

The full-length CPOYA custom orthotic is designed with the teen athlete in mind and provides excellent balance, support, and comfort. This orthotic is made with a revolutionary material called MPAX which is proven to absorb up to 90% of shock, shielding the joints and muscles from stress.

CPOYA also has MPAX Pro in the toe for added propulsion and StanceGuard for full weight-bearing support throughout the gait cycle.

Get the Right Pack for their Back

At this time when parents are purchasing and replacing student backpacks, share your expertise on finding the best ones and helping children use them ergonomically. It’s common to see kids wearing their backpacks improperly. Usually the pack is hanging too low, often around the lumbar spine, pulling down on the neck and upper body. Kids think it looks cool to use only one strap but that exacerbates shoulder and back stress. Neck pain, headaches, shoulder, upper/mid/lower back, and rib pain are some of the more common ailments that can come from poor backpack ergonomics.

A fully-loaded backpack should not weigh more than about 10% to 15% of body weight. For example, if your child weighs 80 pounds, they shouldn’t carry a backpack that weighs over 16 pounds.

There are lots of backpack manufacturers out there but you can recommend those that are healthier for the body and help identify the appropriate backpack style for each patient’s body type and size.

Have the patient bring the backpack into your clinic so you can fit it properly to their body. Most backpacks have adjustable straps that can be tightened so the backpack fits squarely on the upper portion of their back around the height of the shoulder blades. The backpack should sit about 2 inches over the hips. It can’t hang so low that it is around the lumbar spine and puts strain on the upper/mid back as a result.

Another key factor: the weight of the pack also puts extra pressure on the patient’s feet. This further exacerbates over-pronation or over-supination of the feet. Custom orthotics with proper three-arch support are critical for these patients. 

Make Back to School the Beginning of Better Health

Introduce young patients and their families to a wide range of chiropractic benefits through back-to-school care. Visits for sports physicals and backpack fittings open up conversations about foot stabilization and better biomechanics for total body wellness.

Being able to identify and treat foot dysfunction in children, tweens, and teens will expand the patient population you can serve.

Use this school year to establish lifelong proactive health partnerships with patients throughout your community that help you build a more successful practice.

Dr. Kevin M. Wong, DC is a graduate of the University of California, Davis, and a 1996 Summa Cum Laude graduate of Palmer College of Chiropractic West. He has been in practice for over 25 years and is the owner of Orinda Chiropractic & Laser Center in Orinda, CA.

As a member of Foot Levelers Speakers Bureau since 2004, Dr. Wong travels the country speaking on extremity and spinal adjusting. See upcoming events with Dr. Wong and other Foot Levelers speakers at Check out his monthly blogs with proven practice tips to help you achieve optimal patient outcomes.