Kids

KIDS FEET

EARLY YEARS : DEVELOPING HEALTHY FEET

From their first steps, the health of your child’s feet is of significant importance. That’s why we’re always happy to assess your child’s feet, and offer you the best professional advice and treatments available.

Issues with children’s feet are usually discovered through complaints of pain, discomfort or if there is a family history of foot problems such as flat feet. Other issues that require the assistance of a Podiatrist include late walkers, tripping over their own feet or uneven shoe wear.

Our podiatrists will assess your child’s feet and determine if there is a need for further attention or intervention. Possible treatments may include the use of foot strengthening exercises, custom-fit orthotics or footwear advice. Our podiatrists are experienced with treating children of all ages, having also established relationships with local dance schools that often refer students for assessment prior to their commencement of pointe work.

COMMON PROBLEMS SEEN IN CHILDREN INCLUDE:

Ingrown toenails

often caused by tight fitting shoes, socks, or tights which can cause crowding of toes, putting pressure on toenails
don’t cut your toenails properly – for example too short or not straight across
injuring your toe, for example by stubbing it
picking or tearing the corners of toenails
have sweaty feet, making your skin soft and easier for toenails to dig in
have toenails with naturally curved edges or that are fan-shaped.

Warts (verrucae)

Warts are small, firm bumps on the skin caused by viruses in the human papillomavirus (HPV) family. Warts are common in kids and can affect any area of the body. They’re often seen around the fingernails, on the feet, on the face, and near the knees.

Most warts do not hurt, but ones on the soles of the feet (plantar warts)or ones that are frequently bumped into can be painful.

HPV viruses that cause warts can be passed from person to person by close physical contact or from touching something that a person with a wart touches, like a towel. Kids are very likely to pick up this virus at swimming pools or showers.

Kids who bite their fingernails or pick at hangnails are at more of a risk for warts because they create open areas for a virus to enter and cause the wart. A tiny cut or scratch can put any area of skin more at risk for warts. Also, picking at a wart can spread warts to other parts of the body.

We can treat warts successfully in a number of ways, including chemical therapy, cryotherapy (Liquid Nitrogen or Laser therapy )

Toe walking

Toe walking- Refers to a walking pattern in which a child walks on the balls of their feet and there is no contact between the heels and the ground. Most children begin walking at 12 to 15 months of age. When children start to learn walking, they try different foot positions, and walking on their toes may be part of this. By around 24 months, they should walk with their feet flat on the ground. By 3 years of age, children should walk with a heel-toe pattern.

Generally, until age 2, toe walking isn’t something to be concerned about. Often, children who toe walk after that do so out of habit. More than half of young children who toe walk will stop doing so on their own by about age 5.

Most children toe walk occasionally when they’re cruising around a room (by holding on to furniture), especially if they’re on a bare floor. Some kids keep toe walking, off and on, just for fun. Toe walking out of habit, also known as idiopathic toe walking (ITW), sometimes runs in families.

When is it time to consult a podiatrist or GP

walks on her toes most of the time
Has stiff /tight muscles
Is uncoordinated
Walks awkwardly and stumbles all the time
Has fine motor skills that don’t seem to be developing normally
Seems as though can’t bear her weight on a flat foot
Has any other medical problems
Was born prematurely
Has previously walked flat-footed and only recently began to toe walk

In-Toeing

In-Toeing – Children who walk with their feet turned in are described as being “pigeon-toed” or having “intoeing.” This is a very common condition that may involve one or both feet, and it occurs for a variety of reasons.

In cases of metatarsus adductus, the symptoms are easy to see at birth or soon afterward. One or both of your baby’s feet will be turned inward, even at rest. You may notice the outer edge of the foot is curved, almost in a crescent shape.
Internal tibial torsion may not be as obvious until your child starts walking. You may notice that one or both of their feet turn inward with every step.
Medial femoral torsion may be noticeable after age 3, but obvious signs are usually present by age 5 or 6.
In many cases, the foot and knee both turn in as your child walks. It may also be obvious even when your child stands in place. Children with medial femoral torsion often sit with their legs flat on the floor and their feet out to either side in a “W” shape.
There is a related condition called out-toeing. It describes feet that turn outward. The same bone development problems that lead to intoeing can also cause out-toeing

TREATMENT:

Infants with serious metatarsus adductus may need a series of casts placed on their affected foot or feet for weeks. This usually doesn’t happen until a baby is at least six months old. The casts are meant to correct alignment before your child starts walking. Your doctor may show you stretches and massage techniques to help get the baby’s bones growing in the right direction.

Flat Feet

Flat feet- Normally, flat feet disappear by age six as the feet become less flexible and the arches develop. Only about 1 or 2 out of every 10 children will continue to have flat feet into adulthood. For children who do not develop an arch, treatment is not recommended unless the foot is stiff or painful.

Certain forms of flat feet may need to be treated. For instance, a child may have tightness of the heel cord (Achilles tendon) that limits the motion of his foot. This tightness can result in a flat foot, but it usually can be treated with special stretching exercises to lengthen the heel cord. Rarely, a child will have truly rigid flat feet, a condition that can cause problems. These children have difficulty moving the foot up and down or side to side at the ankle. The rigid foot can cause pain and, if left untreated, can lead to arthritis. This rigid type of flat foot is seldom seen in an infant or very young child. More often, rigid flat feet develop during the teen years and should be evaluated
Symptoms that should be checked by a podiatrist include foot pain, sores or pressure areas on the inner side of the foot, a stiff foot, limited side-to-side foot motion, or limited up-and-down ankle motion.

Severs Disease

Severs Disease, also known as “Growing pains” (also known as calcaneal apophysitis) is a common cause of heel pain, particularly in people who are young and physically active. It usually develops around puberty.

Medical and allied health professionals can help manage the symptoms of Sever’s disease so that the young person can continue to take part in physical activity.

Causes:

The Achilles tendon joins the calf muscle at the back of the leg to the heel bone. Sever’s disease is thought to occur because the growth area where the Achilles tendon attaches to the bone (the apophysis) is ‘active’. This means it is beginning to change from cartilage to bone.

During this phase, pre-teens can get pain at the attachment area, or in the tendon or the heel bone itself. This is known as apophysitis. Sever’s disease most commonly affects children between the ages of 8 and 14 years, when growth spurts are beginning.

Symptoms:

A few signs and symptoms point to Sever’s disease, which may affect one or both heels. These include:

heel pain during physical exercise, especially activities that require running or jumping
worsening of pain after exercise
limping – often in the morning, or during or after sport
a tendency to tiptoe

Treatment may include:

cold packs – applying ice or cold packs to the back of the heels for around 15 minutes after physical activity when a flare-up occurs
activity modification
avoiding stretches and ‘eccentric’ exercises (such as lowering your heel over a step or jumping or hopping) in the initial phase
use of a heel raise (in consultation with your health professional) – often just used in any shoes causing the problem, to take the pressure off the apophysis and tendon
support for any biomechanical factors that are contributing to the pain – particularly around the foot. For example, foot taping or doing exercises to improve neuromuscular control around the foot, may be helpful
orthotics (special shoe inserts) – these may help relieve some biomechanical symptoms
medication – pain-relieving medication such as ibuprofen may help in some cases (such as for tendon pain). This should always be combined with other treatment following consultation with a doctor, pharmacist or allied health professional
time – generally the pain will ease in one to two weeks if the person seeks help from an allied health professional, although it can take longer. As the apophysis takes two years to mature (sometimes longer), there may be flare-ups from time to time, triggered by growth spurts, changes in sporting activities, increased intensity, changes in footwear or changes in surface.

Knee pain (Osgood Schlatter Disease)

Osgood-Schlatter disease is a common cause of knee pain in growing adolescents. It is an inflammation of the area just below the knee where the tendon from the kneecap (patellar tendon) attaches to the shinbone (tibia).

Osgood-Schlatter disease most often occurs during growth spurts, when bones, muscles, tendons, and other structures are changing rapidly. Because physical activity puts additional stress on bones and muscles, children who participate in athletics — especially running and jumping sports – are at an increased risk for this condition. However, less active adolescents may also experience this problem.

In most cases of Osgood-Schlatter disease, simple measures like rest, over-the-counter medication, and stretching and strengthening exercises will relieve pain and allow a return to daily activities.

Painful symptoms are often brought on by running, jumping, and other sports-related activities. In some cases, both knees have symptoms, although one knee may be worse than the other.

Knee pain and tenderness at the tibial tubercle
Swelling at the tibial tubercle
Tight muscles in the front or back of the thigh

Your doctor may recommend additional treatment methods, including:

Stretching exercises. Stretches for the front and back of the thigh (quadriceps and hamstring muscles) may help relieve pain and prevent the disease from returning.
Non-steroidal anti-inflammatory medication. Drugs like ibuprofen and naproxen reduce pain and swelling.
Addressing any biomechanical weaknesses with orthoses and strapping