PEDIATRIC FOOT PAIN
If you notice that your child has difficulty walking or keeping up with their peers during sports, they may be experiencing suboptimal foot and ankle mechanics. If children are evaluated and treated while their feet and ankles are still maturing, they can avoid more severe ailments in adulthood.
Pediatric foot pain can be caused by a flatfoot deformity. These patients have a structural weakness from the foot up to the hips. Pediatric patients may or may not complain of pain. Parents notice their children walking and running different than their peers. Even in the absence of pain, parents should have their child’s feet evaluated if they suspect a flatfoot deformity.
It’s best to recognize a pediatric flatfoot at an early age. The earlier a flatfoot can be managed, the better the long term outcome. Recognition starts with parents. Key factors to recognize:
- Your child has difficulty running, or is unable to keep up in sports.
- Your child frequently complains about foot pain.
- When examining your child’s feet from behind, their heel bones tend to tilt outwards, while their ankles tilt inwards
- You will see a decrease in the arch height.
- Your child’s shoes wear down quickly on the inside of the heel.
If you suspect that your child has a flatfoot deformity, schedule an initial consult as soon as possible. Pediatic foot pain and flatfeet can be managed with a medical grade or custom orthotic. Orthotics will align the foot and support the fallen arch. Lower extremity strengthening, as well as glute strengthening is paramount for managing pediatric foot pain and flatfoot deformities. Minimally invasive surgical options are recommended for older pediatric patients if their flatfoot deformity has failed conservative intervention. Reconstructive flatfoot surgery may also be necessary. Reconstructive surgery is reserved for severe cases that have failed all conservative care.
Pediatric Heel Pain
The most common cause of pediatric heel pain is a conditional called calcaneal apophysitis (aka Sever’s Disease). The pain stems from the open growth plate (aka the calcaneal apophysis). A tight calf muscle can cause increased tension of the Achilles tendon at its insertion point on the growth plate, contributing to the painful symptoms. This condition is most commonly seen in active children around the ages of 11-14. Pain always resolves once the growth plate fuses, which is around the ages of 13-15 years old.
To diagnose calcaneal apophysitis, gently squeeze your child’s heel bone. This will elicit pain. If you suspect calcaneal apophysitis, have your child ice their heel after activities. Calf stretching should be implemented twice daily. Decrease weight bearing activities until symptoms resolve.
Pediatric Sports Medicine
Injuries can happen while your child is participating in their favorite sports. If your child is complaining about persistent pain, they should seek medical evaluation. As soon as an injury is diagnosed, physical rehab can start. Your child will then return to their sport stronger and less resilient to injury.
Determine the severity of your child’s pain and adjust their activity levels accordingly. Swimming or other low impact activities are good ways to give your child’s injury a chance to heal. Check your child’s shoe gear to make sure it isn’t worn out. Make sure that your child is spending plenty of time barefoot each day. Walking and running around barefoot will naturally strengthen your child’s feet and allow for optimal foot mechanics.
X-rays will be performed during the initial consult to evaluate for any bony pathology (i.e fractures, growth plate injuries, cysts, tumors). A comprehensive biomechanical exam will be performed. Orthotics may be necessary. Strengthening exercises for the foot and ankle are recommended to rehab the current injury, and preventing future injury.