Parents often report that they are not always sure what issues they should be concerned about with their children’s feet. Here, a podiatrist answers common questions posed by parents.
Q: What are the most common foot problems that children have?
A: We most often see younger children for ingrown toenails, warts, growing pains, flat feet and other gait disturbances, or heel pain.
Q: When should I worry about flat feet?
A: All children have a fat pad in the place where their arch will be until they are around two or three years old. There are certain congenital foot problems that cause severe flattening, and some of these do require treatment. Generally, you do not have to worry about flat feet unless your child complains of pain. Orthotics, or arch supports, can control pronation—the tendency for the arch to collapse and the foot to splay outward.
Q: My child walks on his tip-toes. Is this a problem?
A: Toddlers are often “toe-walkers,” and this is completely normal. However, take your child to see a podiatrist if the toe-walking continues past the age of four. There are several conservative treatments, including physical therapy and inserts. In severe cases, some children will require surgery.
Q: What are growing pains, and how can I help my child when they hurt?
A: It does not actually hurt to grow! The pain is not in the bones; it is in the muscles. The heart needs a certain amount of calcium to function, and it takes this calcium from the muscles, which results in cramping and pain. This can also occur when a muscle is tired from too much activity. The most common ages for growing pains are between three to five and eight to 12. To help alleviate growing pains, make sure your child gets 1,500mg of calcium per day. Potassium is also important (bananas are a great source). It can help to use warm compresses and light massage, and to encourage walking. Bring your child to a doctor if the growing pains limit your child during the day, if the leg is red or swollen, or if your child has a fever.
Q: What can I do to help treat my child’s heel pain?
A: Children between the ages of seven and 13 often develop Sever’s apophysitis, an inflammation of the growth plate in the heel bone. They will often complain of pain in the heels with activity, such as running or playing soccer. To treat this, try rest, ice, different types of shoes, and cushioning inserts. Take your child to a podiatrist if the pain persists or if there is redness, swelling, or bruising around the heel.
Q: What kind of shoes should my infant/toddler wear?
A: Children need to be able to push off at the balls of their feet, and they do not need shoes until they are walking well, around 15 months to two years. Instead, children should wear socks for added protection and warmth. Their first shoes should have soft, flexible soles so that they can push off the balls of the feet correctly. Most toddlers grow an average of a half shoe size every four months until age three. Look for shoes with wide or rounded toe boxes that allow a lot of room for the toes.
Q: What kind of shoes should older children wear?
A: With older children, it becomes important to have more support. The soles should have some flexibility–you should be able to bend the sole a little, but not in half. Children are more likely to have wide-width feet than adults, so make sure you have their feet measured at least once a year. If your children are regularly involved in athletics, be sure they wear the correct type of shoe for their sport (soccer, basketball, softball, etc.) so they will have better foot support for the specific movements to perform each activity.
Janna Kroleski, D.P.M., Assistant Professor for the Arizona College of Podiatric Medicine, specializes in podiatry at the Midwestern University Multispecialty Clinic in Glendale, Arizona. The information contained in this article is not intended to be a substitute for professional medical advice, diagnosis, care, or treatment. Always consult a qualified healthcare provider with any questions regarding any possible medical condition. For more information, visit www.mwuclinics.com/az/ms.