The apple doesn’t fall far from the tree! Flat feet are a common condition that can be inherited. So, if you or your spouse have flat feet, there is a significant chance that your children will have them too. It is important to be aware of how your child’s feet look when they stand and walk.
A child who has flat feet, or pronates, has a heel that tilts out, an arch that drops to the floor, and ankle that rolls inward. This can be normal until about the age of 6 or 7 (the arch is still developing up until that time). It is important to have you child evaluated if their arches appear flat or if their ankles are rolling inward. Flat feet may or may not cause pain. Even if flat feet do not cause pain, they can still affect the body’s alignment which can lead to ankle, knee, hip and back pain.
Proper arch support and realignment of the feet to a more neutral position with either a pre-fabricated arch support or a custom molded orthotic will provide comfort and help prevent future pain and deformity.
Just like adults, kids can develop bunions too. Juvenile bunions are usually inherited or they develop from a particular foot type, such as flat feet. An abnormal position of the bones in the foot and/or abnormal cartilage of the big toe joint can lead to a bunion deformity. Girls are also more prone to bunions than boys.
With any foot condition, nonsurgical options should be explored first. Avoid activities which cause pain. Changing to a shoe with a wide toe box and special padding can prevent pressure over the bunion. Splints worn at night and custom orthotics worn in shoes can slow down the progression of the bunion.
If pain is not relieved by conservative treatments, then surgical options will be considered. Operating on bunions in juveniles is different from operating on adults. A child’s bones are developing and their growth plates are still open. It is best to wait until the growth plates care closed (13-15 in girls and age 15-17 in boys).
Calcaneal apophysitis or Sever’s disease is the most common cause of heel pain in children. Children between the ages of 8-14 years old, who are active is sports, are most commonly affected. The growth plate on the back of the heel bone becomes inflamed by repetitive microtrauma from the pull of the Achilles tendon. Symptoms include pain in the back or bottom of the heel, limping, difficulty running and playing sports. One or both feet can be affected.
Treatment includes x-ray evaluation, reducing activity, heel support, anti-inflammatory medication and stretching.
Just like adults, children develop a whole variety of skin and nail conditions. Mostly commonly, ingrown toenails, warts, sweaty feet, Athlete’s foot, eczema and nail trauma.
It is important to check you child’s feet weekly. Children usually don’t make their parents aware of a problem until there is an infection or pain (pus from an ingrown toenail or pain with walking from a large wart on the bottom of the foot).
Also be mindful of your children walking barefoot, especially in communal areas. Pools, gyms, karate and gymnastics are just a few places where kids can pick up infections such as Athlete’s foot and warts. When possible have you child wear flip flops or slides to protect their feet.
With each new shoe purchase, it is extremely important to follow these simple steps:
- Have your child’s feet measured! We will happily measure your child/children’s feet even without an appointment 😊 (Sometimes one foot can be larger than the other. The larger foot determines the shoe size)
- Allow your child to provide input as far as color and style… if they don’t like the shoe, they won’t wear it!
- Like adults, kid’s feet can swell as the day goes on. Because of this, it is best to purchase shoes in the afternoon or evening.
- With your child standing, place your thumb at the end of the shoe. There should be a thumb’s width of space between the longest toe to the end of the shoe
- Choose a shoe that bends at the natural toe break
- Choose a shoe with a flexible foot bed, this allows the child to feel the ground beneath their feet and allows for better stability
- Try shoes on with socks. Wearing socks provides comfort, reduces friction which can cause blisters and controls odor
An intoeing or “pigeon -toed” gait occurs when the feet turn inward during walking. This occurs when either the foot bones, shin bones or thigh bones turn inward. In most cases, the rotation of the bones in the shin and thigh corrects over time without treatment.
If you notice that your child is tripping or falling, they may benefit from custom orthotics which will place their feet in a corrected position.
When your child is just beginning to walk you may notice that they are walking on their toes or the balls
of their feet. This is a common occurrence in toddlers. With time, most children outgrow toe walking.
If your child is still toe walking past the toddler stage, it is likely out of habit. There is no need to be concerned as long as their growth and development are normal.
Common causes of toe walking include: out of habit (which can run in the family), a short Achilles tendon, cerebral palsy, muscular dystrophy and autism. Treatment depends on the underlying cause.