When your child feet or ankles pain, it can be distressing for you as a parent too. Common children’s feet issues are a real parenting challenge. Remember to understand that there is no such aspect as growing pains. Pain that lasts for more than a couple of days or is severe enough to limit your kid’s mobility or movement is serious. It needs to be seen by a doctor. So, what are the foot problems commonly experienced by children?
Common Children’s Feet Health Issues
#1 Pediatric Flatfoot or Fallen Arches
Kids with pediatric flat foot have no obvious symptoms. But children with flat feet may experience a problem while taking part in sports or physical activities and seem like they are running or walking in a strange way. Some flatfooted kids may also complain of painful sensations or cramping in the knees, legs, and feet. Pain or any kind of difficulty arising out of a child’s feet issues need to be evaluated by a clinician.
Babies are often born with flat feet, which persists into childhood. This takes place because kid’s bones and joints are flexible. This causes feet to flatten when they are standing. Young babies are born with flat feet, which extends well into childhood. This takes place because bones and joints are flexible, causing feet to become flattered when standing. Young babies also have hidden arches because there are fat pads on the feet’s inner border. One can still see the arch if the baby is lifted but it vanishes when he/she stands normally. The foot can also turn out, increasing weight on the inner side and making it seem even flatter.
Generally, flat feet disappear by age six as the feet become lower in flexibility and arches form. Only 1 or 2 children out of every 10 will have flat feet well into adulthood. For those kids who do not develop an arch, treatment is not recommended unless the feet become painful and stiff. Shoe inserts don’t help the child to develop an arch and causes more problems than being flat footed itself. Certain forms of flat feet are treated in a different way. A child may have heel cord tightness or Achilles tendon that limits foot motion.
This tightness results in flat feet, but it can be treated with special exercises for stretching to lengthen the heel cord. Sometimes, a child will have truly rigid flat feet which is a condition that can lead to problems. These kids have difficulty in moving the feet up or down or even side to side at the ankle. Rigid feet cause pain and can even exacerbate arthritis when left untreated. This type of rigid flat foot is often not seen in infants or young kids. The rigidity of flat feet develops during teen years and need to be evaluated by the kid’s pediatrician.
Symptoms that can be evaluated by a pediatric doctor include foot pain, sores, or pressure areas on the inner foot side, a stiff foot, and limited side to side foot motion or limited up and down ankle motions or activities. See a foot doctor or pediatric orthopedic surgeon experienced in children’s feet conditions.
Those without the curve have flexible flatfeet. This means more of your child’s feet are in contact with the ground. In a typical foot, the arch does not touch the base. Most children may be born without any arch, but within 2-3 years of age, arches develop once kids have been walking for a while. Wearing the perfect shoes, ones that are flexible and not stiff help kid’s feet develop the regular way. Flat feet do not need surgery.
Most children have these and other allied conditions that get corrected as time passes. As kids grow, some conditions correct themselves without treatment. Others don’t become more severe on account of other medical or scientific conditions. Many orthopedic conditions, like cleft chins and dimples, are normal variations of human anatomy that don’t require treatment. Flat feet are treated if they are painful. Special footwear is not recommended as this does not affect arch development.
Parents sometimes worry that flat feet can make one clumsier. This is not true and doctors say that while flat feet are not a cause for concern, inserting arch supports into shoes reduce feet pain.
#2 Sever’s Disease/Calcaneal Aphophysitis
This is a painful inflammation of the growth plate of the heel. It impacts children between the ages of 8-14 years old. The condition is because of improper development of the heel bone or calcaneus, which is not fully developed until a minimum of 14 years of age. Till then, new bones are forming at growth plates. Growth plates are also known as physis and are an area at the heel’s posterior with weakness. When there is too much stress on growth plates, swelling can happen due to RSI or repetitive strain injury.
The calcaneus known as the heel bone has an area where the growth of the bone known as apophysis grows. It is situated at the back of the heel bone, where the Achilles tendon is attached. The growth plate is associated with pulling and tension from the tendon leading to a painful heel. Calcaneal apophysitis is also called Sever’s disease. The condition can be further aggravated by rising activity, especially if a strain is placed on the Achilles Tendon from running, jogging or sprinting. Examples range across heel pain from basketball and soccer.
#3 Ingrown Toenails
If nails are trimmed in a wrong way or tight shoes or socks are worn, ingrown toenails happen in the child. Additionally, the tendency for the nail to curve inwards is genetic. When the nail breaks the skin, infections that are serious can happen. Parents should never aim to dig the nail out; a doctor’s expertise is required.
#4 Plantar Wart/Verruca Plantaris
Plantar Warts or verruca plantaris are specifically caused by HPV or human papillomavirus that causes warts in other parts of the body. HPV induced plantar warts may occur in kids and teens. These warts appear the base of the feet or the plantar region. These warts can make it very hard to walk or stand.
#5 Heel Pain
Heel pain may be common in adults, but children and adolescents also suffer from it. Several conditions lead to heel pain in young persons. Exploring the difference between usual growing pains and heel pain indicates a serious condition. While heel pain is generally thought to be a growing pain, it can be something more serious. What is important is that mild or short-lived pain is the only indication it’s a growth spurt. In fact, growth spurts result in muscle or tendon strains that lead to mild discomfort and pain.
#6 Achilles Tendonitis
Much like calcaneal apophysitis, Achilles tendonitis results from the strain on the Achilles tendon by increased activities or tightness of calf muscles experienced by kids during growth spurts. The tendon pains when there is an activity like running, jumping or sprinting. In the morning, there is also stiffness and pain.
Bursitis is another condition which can affect kids. There are pain and inflammation where the heel bone attaches to the Achilles tendon. Bursitis results from the inflammation of the bursa, a fluid pocket adjacent to the tendon. Bursitis is caused by irritation or tendon strain from rubbing against a tight shoe.
#8 Plantar Fasciitis
Pain on the bottom of the heel is caused due to plantar fasciitis. This condition results from heel bone underside inflammation or swelling. This is where a band of connective tissues called the plantar fascia attaches. Plantar fasciitis is caused or further accelerated by issues with foot function such as flat or high arched feet. Children may also report more pain in the morning and post an active day.
#9 Pigeon Toes
Pigeon toes or toes inwardly turning is a common feet condition in children. It takes place when the front of the feet are turning inward, facing the other feet. Male as well as female children experience this condition. Most children’s’ feet straighten naturally sans medical treatment.
When kids stand with their feet and ankles together, but knees wide apart, it is called being bow legged. Many infants are born bowlegged with legs folded tightly across bellies when growing in the belly. Bowlegs generally straighten once babies with this condition start to move and their legs carry their weight. By 3 years of age, most kids grow out of this condition. Being bow legged (also known as genu varum) is an exaggerated or obvious outward bending of the legs from the knees down that can be inherited. It’s common in infants and corrects itself as the child grows. Being bowlegged beyond 2 years of age or bow-leggedness impacting only one leg is an indication of a larger problem, such as Blount disease or rickets.
Rickets is a bone-growth problem caused by lack of calcium or vitamin D in the human body. It leads to the bowing of the legs and also triggers muscle enlargement and pain of the liver and the spleen. Rickets is less common today than in the past days. By adding calcium and vitamin D, rickets and the resulting bowlegs are corrected using a diet. Some kinds of rickets are due to genetic conditions and need specialized endocrinological treatment.
Another condition that leads to bow-leggedness is Blount disease which affects the tibia bone in the lower leg. Leg bowing from Blount disease is seen when the child is around 2 years old; it appears suddenly and rapidly becomes worse. Blount disease’s cause is not known but what it is associated with is an abnormal growth at the knee joint atop the tibia bone. For correcting this, kids may need surgery between three and four years of age. One should take the child to the doctor if the bow-leggedness is on one side or progressively worsens.
#11 Knock Knees
Most kids have somewhat of a tendency for knock knees also known as genu valgum. It generally takes place between the ages of 3 and 6 as the body enters a natural alignment shift. Treatment is not required mostly because legs generally straighten out on their own. Severe knock-knees or knock-knees on one side of the legs do not require treatment. Devices like splints, shoe inserts, and braces are no longer helpful or useful. In special cases, where children have symptoms such as difficulty running or pain, surgery may be considered after age.
Knock knees are a condition where legs curve in at the knees so angles have been separated by a width. A lot of kids become knock-kneed between ages 3 and 5. But around the age of 6 years, the body starts straightening naturally and can stand with their knees and ankles pressing together.
What such conditions have in common is that they are resulting from physical stress on the feet. Once the diagnosis is made, treatment plans involve resting and daily stretching of the ankle and the feet. Physical therapy is recommended to improve strength and flexibility.
In the event that structural or functional issues with a child’s foot are resulting in heel pain, shoe doctors may prescribe or suggest shoe orthotics or some other footwear change. An ankle brace or support is also prescribed.
#12 Toe Walking
Toe walking is common among kids who are toddlers learning to walk, especially during the second year of life. This tendency often disappears by around 3 years of age but lasts in some kids. Occasional walking on the toes is not a matter for worry. But kids who walk on toes almost all the time, and continue to do so after age 3 need to see a doctor. Toe walking, in such cases, could signal conditions like muscle weakness, cerebral palsy, autism or even other issues in the nervous system. If a healthy child is persistently toe walking, the doctor can recommend some visits to physical therapists to acquire an understanding of stretching exercises. Once children are aged around 4 or even 5, casting the foot and ankle for about a total of six weeks may be needed to stretch the calf muscles.
#13 In Toeing/Pigeon Toes
When babies begin to stand, they may have a legs naturally turning in between 8 and 15 months of age, when they start standing. As they become older, parents notice their children walking with feet inwards, also called walking pigeon-toed or in-toeing. In-toeing can have few causes that are normal variations in the way legs and feet are lining up. Children who are in-toe and trip may have internal tibial torsion, where the inward rotation of the lower part of the leg takes place. Children above 3 to 4 years of age with in-toeing have femoral anteversion, where there is an upper leg greater-than-normal bend. This can cause the upper leg to rotate inwards. In certain children, in-toeing can be related to medical problems like cerebral palsy. Doctors rarely treat pigeon-toed feet. In the past, special shoes and braces could never speed up the improvement. In-toeing does not come in the way of running, walking or sports and stops on its own, as children grow into teens and develop better muscular coordination and control.
If treating common causes for pain in the feet or heel does not result in immediate improvement, seeking medical evaluation and assessment is a must. Inflammatory conditions such as juvenile rheumatoid arthritis as well as juvenile spondyloarthropathies lead to heel pain. The latter includes reactive arthritis, ankylosing spondylitis, and psoriatic arthritis. Tarsal coalitions or congenital bone fusions also result. There are also bone fractures and possibilities like Crohn’s Disease and Ulcerative Colitis. Another rare condition is tumors or cysts which should be diagnosed through X-ray imaging.
Thus, while common conditions affecting your child’s feet are many, you can take immediate action by visiting a pediatric specialist or podiatrist and ensure your child is comfortable and pain-free.