New England PodiatryNew England Podiatry
Children often exhibit flat feet. Flexible pediatric flatfoot occurs when the arch of the foot disappears when the child stands and then reappears upon sitting. Most children with this condition are born with it and will usually outgrow it by age 5.
Rigid flatfoot is rarer and the arches will not reappear when the child sits down.
Symptoms
Most children with this deformity have no symptoms, but some will feel cramping in the feet or legs or foot pain. The heels may seem to tilt outward and you may notice a change in walking. Walking may cause pain and so the child may withdraw from physical activities and sports.
Rigid flatfoot may cause more serious symptoms
Treating Pediatric Flatfoot
Children outgrow pediatric flatfoot without treatment in most cases. However, if your child is experiencing pain, we can recommend a custom-fitted orthotic device that fits into your child’s shoe to help support the arch and ease pain. Older children may benefit from stretching exercises and physical therapy.
In rare cases, surgery can help rigid flatfoot and chronic pain.
An ingrown toenail is when the sides of the nail grow into the surrounding skin and tissue. Cutting into the skin like this may cause inflammation and infection.
Ingrown toenails may be very painful and make it difficult to wear closed-toe shoes. They are very common in teenagers.
Symptoms
The skin around the ingrown nail may appear red and warm. The damaged skin will allow bacteria to enter and then cause an infection.
When infected, the skin will become painful, red and swollen. There may be discharge of fluid or pus around the nail.
Without professional treatment, this infection may lead to a skin infection called cellulitis or even osteomyelitis, or infection of the bone.
Treating Ingrown Toenails
If the ingrown toenail is in its early stages, wearing wider shoes and trimming the nails straight across can help resolve the problem. Soaking the foot in warm soapy water and bandaging when shoes are worn can help ease the pain and inflammation.
If the toenail becomes infected or you see a discharge, please see a foot doctor. We will remove part of the toenail under local anesthetic and apply medication to stop the problem edge of the nail to regrow.
Preventing Ingrown Toenails
Always cut your child’s toenails straight across rather than rounding and don’t cut them too short.
Your child’s shoes should fit well and have ample room for the toes.
Children often start walking with their toes and feet turned at an angle. “In-toeing” means the feet turn inward – sometimes referred to as walking “pigeon-toed” – while if they point outward, it’s called “out-toeing.” Most children walk with in-toeing or out-toeing which usually improves as they get older.
Most toddlers walk with in-toeing or out-toeing because of a slight twist or rotation of the lower or upper leg bones. It is uncertain why some children have these gait
abnormalities, but a family history may play a role. Cramping in the womb may also contribute to these conditions.
Symptoms
Most children have no symptoms other than observed walking with toes pointing in or out. However, some may exhibit pain in the foot, knee, thigh or hip by limping.
Treating In-toeing and Out-toeing
If your child’s in-toeing or out-toeing doesn’t improve by age 3, if he or she has pain, if one foot turns out more than the other, if gait abnormalities worsen or if there are other developmental delays, please come in for an evaluation.
Some types of torsions may require surgery to untwist the bones to prevent more serious problems when the child is older.
Heel pain in children, although usually not serious, should be looked at and properly treated. These injuries can develop over time and often are due to overuse in rigorous sports training, especially running and jumping.
The most common causes of pediatric heel pain are Sever’s disease, an injury to the growth plate in the lower back of the heel, and Achilles tendonitis, an injury to the Achilles tendon that connects the calf muscles to the heel bone.
Symptoms
Sever’s disease causes pain in the back of the heel, especially when squeezing the back of the foot. You may see swelling and warmth in the area. The child may limp or walk on their toes.
With Achilles tendonitis, the child will feel pain in the heel or the back of the foot. The pain may be mild and then gradually get worse. He or she may have difficulty walking.
Treating Pediatric Heel Pain
Treatment depends on the cause of the heel pain. For Sever’s disease, treatment includes stretching the calf muscles, icing the area and pain medications. Custom orthotic devices can help redistribute pressure. Rest and cushioned heel lifts can help the child return to normal activities in 3 to 6 weeks.
With Achilles tendonitis, the RICE method of rest, ice, compression and elevation can help ease symptoms. Anti-inflammatory medications like ibuprofen can help relieve pain and swelling. Stretching can help to minimize re-injury.
Prevention
You can reduce your child’s risk of heel pain by:
Youth safety when playing sports should be of utmost importance for the athletes, parents and coaches. Young athletes should not play or practice through the pain of a sports-related injury. Continuing to stress the injury can cause even more damage and may even end an athletic career.
Teach Your Child To Report an Injury
Teens and children should be coached on the limits of their bodies. Teach them to speak up when they feel pain and that it’s okay to sit on the bench until fully healed.
Be alert to signs of pain or injury including an unusual gait; limping; favoring a foot. Stop the activity and visit your foot doctor for professional help.
Preventing Youth Sports Injuries
A sprain is an injury to the ligaments that connect bones to one another. This type of injury occurs when the ligament is excessively stretched or even torn.
The most common type of sprain for a child is an ankle sprain.
Symptoms
The symptoms in a child of a sprain are similar to those for a fracture and include:
Treating Ankle Sprains
If after icing the ankle and resting the pain and swelling continue, visit a foot doctor. Treatment usually involves immobilization with a splint or compression with an elastic bandage. For a severe injury, a walking cast will help with immobilization.
If the swelling comes back or the pain persists, be sure to follow up with the podiatrist again to prevent chronic ankle instability.
Preventing Ankle Sprains
Toe walking, or walking on the toes or the balls of the feet, is common in toddlers who are just learning to walk. Most children outgrow it.
A child who continues to toe walk may do so out of habit. Generally, toe walking is not likely a cause for worry. However, toe walking may result from a shortened Achilles tendon as well as conditions such as muscular dystrophy, cerebral palsy and autism spectrum disorder.
Symptoms
You will observe your youngster walking on his or her toes, or the balls of the feet, instead of placing the heel down first. In some cases, the child will have reduced coordination and balance.
Treating Toe Walking
Your foot doctor will monitor your child’s gait. If a physical problem is diagnosed, treatments may include:
Warts are caused by viruses in the human papillomavirus (HPV) family. When they appear on the soles of the feet, they are called plantar warts because they grow up into the feet toward the plantar fascia tissue. Plantar warts are especially common in children and teenagers.
HPV viruses are very contagious. For children, it’s easy to catch the virus on the soles of their feet when walking barefoot in public areas such as locker rooms, swimming pools and gym showers.
Symptoms
A plantar wart on the bottom of the foot can be very painful as it grows deeper. It can feel like you are walking on a pebble.
You may observe a grainy spot on the sole of the foot or a callus that has grown over a pinpoint plantar wart.
Treating Plantar Warts
Many plantar warts will go away by themselves. However, if it is painful for your child or the warts are spreading, see a foot doctor for permanent relief.
Treatment options include:
Preventing Plantar Warts
You can minimize the risk of plantar warts for your child by: