Abstract: This article provides an in-depth analysis of how to utilize SennoScan plantar pressure mapping to evaluate pediatric development. Clinical research indicates that rather than focusing solely on flat foot screening, the true value of pressure mapping lies in identifying compensatory strategies and postural control issues within the entire kinetic chain—such as hindfoot valgus and knee valgus. This approach enables early intervention for potential spinal scoliosis caused by malalignment.
When many people look at a plantar pressure map, their first reaction is to ask: “Is this flat foot? How severe is the collapse?”
However, from a clinical perspective, the more critical question is: What is the distribution of force across the plantar surface? Does it reflect abnormalities in the child’s postural control strategy?
This gray-scale plantar pressure map belongs to a 12-year-old girl. While pressure distribution is visible on both the left and right feet, the right foot does not display the typical “total collapse” of the arch.
What warrants closer attention, however, is not the status of the arch collapse itself, but rather the clinical observation of a pronounced right hindfoot valgus (rearfoot eversion), compounded by the fact that she already presents with scoliosis.
When we look at these three pieces of clinical data together—the abnormal footprint, the right hindfoot valgus, and the scoliosis—it strongly suggests that this is not a localized, isolated foot problem. Instead, it points to a systemic, structural alignment issue within her overall growth and development.
Don’t jump to conclusions about “flat feet” just yet
While the height of the arch is undoubtedly important, it is only one piece of the foot’s structural puzzle.
What can easily be missed in a clinical setting is this: some children appear to still have an arch, and may not even show noticeable collapse during static standing, yet their hindfoot has already begun to evert (roll outward), silently shifting the body’s center of gravity.
Cases like this often indicate that the issue isn’t “damaged structure,” but rather that the body’s control mechanisms have already begun to compensate. In other words, the child is using a strategy that “just barely manages to maintain standing balance.” However, this strategy is neither efficient nor stable over the long term. If this pattern persists, the mechanical load can easily transfer from the foot up to the knee, hip, and pelvis, ultimately impacting the spine.
Why hindfoot valgus matters more than many parents realize
Many people fixate solely on the arch while completely overlooking the rearfoot.
In reality, hindfoot control often flags potential issues much earlier than arch morphology does. The presence of right hindfoot valgus means the rearfoot is failing to maintain a proper neutral alignment while standing.
This deviation typically triggers a cascade of biomechanical consequences:
- Increased internal rotation of the tibia (shinbone)
- Altered alignment of the knee joint
- Compensatory stress placed on the hip and pelvis
- Reduced stability of the trunk’s midline
Therefore, right hindfoot valgus is never an isolated phenomenon; it acts more like a “signal flare” within the entire kinetic chain. When a child already presents with scoliosis, this signal cannot simply be written off as a mere “postural habit.”
Why Plantar Pressure Maps Help Clinicians Determine Direction
The value of this type of imaging lies not in providing an absolute diagnosis, but in helping clinicians answer a critical question:
Is the anomaly rooted in structure, or in control?
- Structural issues typically involve evident, established changes in the bones or soft tissues themselves.
- Control issues, on the other taken, frequently manifest as disrupted center-of-gravity shifts, uneven bilateral weight-bearing, hindfoot valgus, irregular gait rhythms, and fixed compensatory pathways.
For this 12-year-old child, the plantar pressure map tells us at least three things:
- The loading pattern of her right hindfoot is suboptimal.
- The relationship between her left and right sides is not a simple matter of “symmetry vs. asymmetry”; rather, there is a distinct divergence in her weight-bearing strategies.
- When viewed alongside her scoliosis, the foot anomalies appear to be an integral part of her overall postural control mechanism, rather than an isolated, localized issue.
In other words, this scan is not telling us whether or not she has flat feet. Instead, it serves as a prompt: her body’s kinetic alignment may have already formed a biased usage pattern.
How Parents Should Interpret This Scan
The most common mistake parents make is treating a plantar pressure map as a definitive “final verdict.” In reality, it is much more of a screening tool—a warning signal.
Further clinical evaluation is highly warranted if a child exhibits the following:
- Fatiguing easily after standing for short periods
- Uneven shoe wear (one side wearing out significantly faster)
- A noticeable shift in the center of gravity to one side while walking
- The co-existence of hindfoot valgus, knee valgus (knock-knees), and pelvic instability
- An existing diagnosis of scoliosis, or currently undergoing a pubertal growth spurt
When these presentations overlap, the significance of a plantar pressure map increases exponentially. It helps parents realize that while the issue might not be catastrophic yet, it is certainly not something the child will simply “outgrow.”
Clinical Implications and Takeaways
From a clinical reasoning perspective, children presenting with these patterns require a comprehensive kinetic chain assessment rather than an isolated focus on foot orthotics.
Key areas that demand close attention include:
- Whether the hindfoot valgus is persistent and rigid
- Whether bilateral support remains chronically unbalanced
- Whether the interconnected mechanics of the knee, hip, and pelvis are already compromised
- Whether the scoliosis is accompanied by trunk rotation and a shifted center of mass
- Whether the child can successfully shift their center of gravity back to a neutral, centered position during static standing and dynamic ambulation
To perform a truly meaningful evaluation, clinicians cannot rely solely on static snapshots. The presentation must be observed across multiple functional contexts, including standing, walking, gait transitions, and single-leg stance. Many subtle issues that remain hidden in a static posture will immediately expose themselves under dynamic load.
The True Value of These Scans
The greatest value of a plantar pressure map is not proving that “something is wrong with the foot.” It is helping the clinician pinpoint where the biomechanical dysfunction originates and how it propagates up the chain.
During a child’s developmental years, most postural deviations do not appear overnight; they are slowly consolidated through long-term chronic compensation.
Therefore, when reviewing a scan like this, the priority should not be rushing to label or pigeonhole the child. Instead, the focus must be on making an early determination: Is she currently within a normal range with a slight deviation, or has she already crossed into a phase where she is actively compensating for a structural shift? The intervention intensity, sequencing of therapies, and follow-up frequency will look completely different for each scenario.
Conclusion
What this scan reminds us most urgently is not to obsess over whether the arch has collapsed, but to look at whether the child’s body has begun using a fixed, maladaptive strategy to bear weight. For a 12-year-old child, allowing this pattern to persist unaddressed means that down the road, we will not just see structural changes in the feet—we will likely face far more complex lower limb and spinal pathologies.
Plantar pressure mapping allows clinicians to detect compensation earlier and helps parents grasp the associated risks sooner. Ultimately, it ensures that interventions can be introduced while the system is still adaptable and capable of change.
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