The bone structure of the child’s foot is well formed by the age of 7 or 8, but the growth plates (areas where bones grow) are still open and fragile. If a growth plate is injured and timely treatment is not rendered, the child’s bone may begin to grow abnormally or even stop growing. However, with proper care, the risk of future bone problems can be reduced.
It is common for active children (boys more so than girls) between the ages of 9 and 13 to have heel pain. This is due to inflammation of the growth plate within the heel bone from activity and the surrounding structures (Achilles tendon and plantar fascia) being tight. Symptoms can be successfully relieved with treatment by your podiatrist, including icing, heel lifts, orthotics, and stretching. X-rays are always taken to ensure the child is not suffering from any other conditions, such as a fracture or bone cyst.
Remember to check your child’s shoe size often. Make sure there is space between the longest toe and the end of the shoe, and enough room to allow the toes to move freely. Don’t let your child wear hand-me-down shoes. Your child’s shoes should be in good condition in order to be protective and supportive. Quality supportive shoes should only bend at the toe joint or ball of the foot. You should not be able to bend the shoe in half or twist the shoe easily, these are signs of an unsupportive shoe. Be sure to purchase the correct shoes for your child’s specific sport or activity.
Common Pediatric Foot Problems
Warts and ingrown toenails are common conditions among children and can be treated successfully by your podiatrist. Ingrown toenails can be painful and cause infection. Signs of infected ingrown toenails include redness, swelling, drainage, and pain to the border of a toenail. To avoid ingrown toenails, try cutting the nails straight across and not into the corners. This allows the straight edge of the nail to advance as one unit. Cutting the toenails in a curved pattern allows the recessed edges to grow into the skin. Trimming your nails too short can also cause ingrown toenails. When trimming your nails there should be a few millimeters of the white tip beyond the nail margin. Nails should not grow to overhang the edge of the toe.
Warts look similar to calluses, they are raised skin lesions, often have dark spots, and are painful when squeezed. Warts can be treated with over-the-counter medications, but are often stubborn and require medical treatment. Warts should be treated to avoid spread of the infection to the foot and other people.
The size and shape of your baby’s feet change quickly during their first year. Since a baby’s feet are flexible, too much pressure or strain can affect the shape of their feet. It’s important to allow your baby to kick and stretch his or her feet freely. Be sure that their shoes and socks do not squeeze their toes. Flat feet (fallen arches) seen during infancy is normal.
Do not force your toddler to walk before they are ready. Once they are walking, carefully watch their gait (walking pattern). Pay attention to make sure your toddler’s toes do not touch down before their heel. This is known as toe walking and should be avoided. Many toddlers have a pigeon-toed or in-toed gait. This is a normal pattern seen early in life and is outgrown within a couple years. If in-toeing persists, then physical examination by your doctor is necessary and custom orthotics (inserts) or braces may be prescribed. To prevent or improve in-toeing, try to stop your child from sitting in the W position. In this position, a child sits on their bottom, with knees bent, feet tucked under, and legs splayed out to each side in a “W” configuration.
Flat feet (fallen arches) is another condition that can be seen early in childhood. Depending on the severity of the condition, this can be treated with custom orthotics (inserts) and/or surgical correction.
It is not normal for your child to experience chronic foot and/or ankle pain. If you notice any of the previous conditions, please contact our office for an evaluation of your child’s feet and legs. Children with strong, healthy feet often avoid many lower extremity conditions later in life.