February 28, 2019

As with most bones in a child’s body, those in the feet do not fully mature until the teenage years. Children’s feet are still soft and flexible to withstand various physical stresses while they learn balance and coordination. It’s also during this period that children are most likely to develop certain foot conditions and, therefore, require proper foot care from their parents, pediatrician, or an orthopedist.

Below are pediatric foot conditions that are common in children and which require immediate medical attention and proper treatment.  

Clubfoot

This is a congenital deformity - i.e., a condition that is present since birth - characterized by feet that are twisted both inward and downward. Clubfoot is usually treated through gentle stretching and casting, called the Ponseti method, which must be done by a doctor. Early treatment is important to prevent difficulties in learning how to walk and even permanent deformity.  

Foot and nail fungal infections

Fungi thrive in warm and damp places, and children can be susceptible to foot and nail fungal infections because their feet sweat a lot. A child can get athlete’s foot or fungal nail infections from walking barefoot around public pools or in public showers. They can also get infections if they share a towel or a pair of nail clippers with somebody who is already infected. Making sure to thoroughly clean and dry your child’s feet and toes, especially in between the toes, can help prevent these infections.

Gait abnormalities

  • In-toeing, also known as being pigeon-toed, is a common rotational deformity in young children and is characterized by the legs and feet twisting inward. The condition usually corrects itself over time. Examination by an orthopedic doctor/surgeon can help determine the exact cause and whether or not treatment or therapy is needed.
  • Out-toeing is less common than in-toeing and is characterized by the toes of each foot pointing outward and away from each other when walking or running. The condition is usually inherited and also corrects itself over time. A thorough examination is needed to find out if it is caused by a more serious, underlying issue.

Ingrown toenails

Having an ingrown toenail can be hereditary, or it can be caused by injury, improper nail trimming, or tight shoes. The condition can be easily remedied at home with a foot-soak in room-temperature water and a gentle massage of the inflamed nail fold. Surgically removing the ingrown toenail should only be done by a doctor.

Juvenile bunions

The painful condition is usually inherited and is characterized by the formation of a bony bump at the joint of the big toe as it bent towards the 2nd toe. The affected joint eventually becomes arthritic and painful, especially when inside a shoe. Untreated juvenile bunions can grow larger and more painful. Proper diagnosis and treatment should be done by a qualified doctor as soon as possible to prevent worsening of the deformity and avoid surgical intervention.

Pediatric flat foot

This condition is characterized by a partial or total collapse of the arch of the feet, i.e., the arch disappears when standing and even when on tiptoe. It can be congenital, or it may not develop until years later. Most toddlers with flat feet eventually develop arches around the age of six. Those who don’t develop arches should be examined to determine what kind of treatment may be needed.

Sever’s Disease

This is heel pain that is common among active children, especially those engaged in sports that require a lot of running and jumping. It usually occurs during their growth spurts and is caused by repetitive stress to the heel. Pain management mostly involves rest from activities that stress the affected heel. The condition usually goes away within a few months.

Stress fractures

These are an overuse injury caused by repetitive stress, usually from sports. Stress fractures commonly occur in the shin bone and foot. The hip may also be affected. Stress fractures occur due to improper execution of an activity or overtaxed muscles that are not allowed adequate time to rest and rebuild. Rest is the primary form of treatment for stress fractures. The use of crutches or a wheelchair and physical therapy may also be recommended by

a doctor.

Tarsal coalition

This is a type of flat-footedness that occurs when two or more tarsal bones - the bones at the back and in the heel of the foot - become abnormally connected. The condition causes pain and usually appears in adolescence.

Most pediatric foot conditions do not require medical intervention. With proper care and management, as well as simple changes such as wearing better-fitting shoes, these conditions eventually resolve themselves over time. Medical interventions, when necessary, usually only require physical therapy and/or the use of orthotics (custom-made foot support) or other equipment, like crutches.

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The health of children’s feet is often taken for granted, but, as parents, we have to remember that the feet are also vital to our children’s lifelong health and quality of life. They will literally take them places, after all! We should keep an eye out for signs of foot discomfort or pain, as well as any abnormalities in the shape and form of their feet or our children’s gait and balance. These could point to an underlying condition that, when left untreated, could lead to long-term pain, deformity, and physical restrictions.