Paediatric Consultations

Paediatric Consultations

Looking after your Children’s Feet!

Podiatric services for children start with a paediatric assessment which helps determine irregularities in children by carefully examining their walking and gait patterns. Children’s feet differ from those of adults as they are not completely moulded.  With this in mind the podiatrist are aware of the developmental milestones and patterns of growth of children’s feet and can diagnose and treat children’s foot problems by carefully examining the feet and legs, while also considering other factors such as family history, sports or other physical activities, shoe wear and additional medical conditions and can differentiate certain features such as in-toes, flat feet or knocked knees and begin to commence corrective procedures.

Our Podiatrists are trained to treat common, chronic and acute problems in children of all ages. If you notice that your child has the following signs and symptoms, come and see us for a friendly consultation:

Excessively pronated feet, “rolling in” of feet or ankles or flat feet. Over pronated foot type, also called pes planus in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. This over-pronation is common in all age groups and occurs as a part of the natural development process of a child’s foot during pre-school years. Although your child may grow up to have flat feet, excessive pronation can later contribute to foot, ankle, leg, knee, hip and lower back pain.

Excessively supinated feet, “rolling out” of feet or ankles or high arched feet. A supinated foot type, also called cavus foot in which the foot has a very high arch (supination). Because of this high arch, an excessive amount of weight is placed on the ball and heel of the foot when walking or standing. It is less common but similarly to flat feet it can cause problems with the lower limb alignment when walking and running, affecting the biomechanics of the rest of the body. A child that presents with high arch feet or feet that roll out can increase the risk of injuries such as ankle sprains and fractures.

Sever’s Disease or Calcaneal Apophysiitis, growing pains or heel pain. Sever’s is related to the inflammation of the growth plate of the calcaneus or the heel bone. It is the most common cause of heel pain in children. Sever’s is often seen in active children between the ages 8 and 14, because the heel bone (calcaneus) is not fully developed until at least age of 14. The repetitive stress on the growth plate due to overuse, sudden increase in activity and rapid growth spurts causes inflammation and pain in the heel when walking and running. Children at risk for developing this condition present with either a flat or high arched feet, poor- fitting shoes, one leg is shorter than the other, or weight gain.

Knee pain or Osgood–Schlatter disease (OSD), also known as apophysitis of the tibial tubercle, is an inflammation of the patellar ligament at the tibial tuberosity or bony bit at the top of the shin. It is characterized by a painful bump just below the knee and is most often seen in young adolescents. Osgood Schlatter syndrome is primarily an over use injury predominantly in sports involving running, jumping and quick changes of direction.

Arch Pain or Kohler disease is a condition that affects a bone at the arch of the foot called the tarsal navicular bone. It occurs most frequently in children between the ages of 5 and 10 years. Signs and symptoms of the condition include pain, redness and/or tenderness and swelling in the middle part of the foot and usually can lead to a limp or abnormal style of walking.

In-toeing or pigeon toe walking or adducted gait is when the feet turn inwards when walking. It is common in childhood and usually children grow out of it. It is important that as parents you have this assessed to determine if excessive or not and if needed treated to prevent injuries and more serious conditions in their future such as lower back, hip, knee and ankle issues. If your child appears to be walking in-toed it can be attributed to three common causes;

– Metatarsus adductus:  The outside of the foot is normally straight. In metatarsus adductus, the bones in the front half of the foot bend or turn in toward the side of the big toe.

– Internal tibial torsion:  (The lower leg) Internal tibial torsion is where the bone of the lower leg turns inwards between the knee and the ankle. It is very common in infancy and  childhood

– Internal femoral torsion:  (The thigh bone) Internal femoral torsion is where the thigh bone turns inwards between the hip and the knee.

Out-toeing or ‘Duck’ feet is a condition in which a person walks with the toes pointed outward and can occur in one or more of the following three areas;

– Pes planus or flat feet; where the child has no arch in their feet

– External tibial Torsion out-toeing. The outward twisting of the lower leg bone

– Hip Contracture and out-toeing. Born with externally rotated hips  defect. This is a rigid, non- reducible or fixed congenital deformity involving one foot or both. The Child’s affected foot appears to be “bowed” at the ankle. The feet are in a twisted position facing the centreline of the body, (clawed) so that if the child walks, it is on the outside edge of the foot.

Skin rashes, hard skin lumps or bumps on your child’s feet. Podiatric treatment is needed in many of these cases to rectify these conditions including;

– Ingrown toenails, tight shoes or socks, or improper nail trimming are the most common cause of ingrown toenails in children, although sometimes heredity plays a part in the nail shape. Causing the nail to break the skin and causing an infection in the tissue surrounding the nail.

– Athletes foot or Tinea Pedis is a common skin infection of the feet caused by fungus.

– Warts or also known as verrucae. Children tend to be more susceptible to warts than adults. A plantar wart is often on the sole of the foot that appears to be hard and flat, with a rough surface and well defined boundaries.  Verrucaes can also occur on other parts of the foot.

The child’s foot is not just a small-scale model of an adult foot. They are very flexible and the bones are soft and cartilaginous. Its shape is not finally determined until growth ceases at the end of the second decade of life and while your children’s feet are still growing they are extremely prone to injury via, womb position, improper footwear, hereditary influences and poor development. It is therefore vital for correcting any developmental and structural abnormalities in the early childhood period of their lives.

So let our expert team at One Step Podiatry look after your kids’ feet and help set them right for the future!