It’s important to pay attention to your child’s feet to help keep them fit and healthy. In this guide, we look at the problems that may arise in children’s feet and the symptoms to look out for. We also offer some tips to consider when buying children’s shoes and the importance of a foot health check in children’s foot care.
What problems may arise in children’s feet?
Toe walking is a walking pattern commonly seen in children who have just started to walk. It occurs when a child walks on the ball of their foot instead of having their feet flat on the floor.
This way of walking is not always of concern since most children outgrow it. If toe walking continues beyond toddler years, it could be a habit or indicative of a serious disorder. These disorders can include short/tight Achilles tendon, Cerebral palsy, muscle dystrophy and autism. You should see a podiatrist at this stage.
The foot structure of flat feet is associated with a flattened arch on the inside of the foot.
From the age of 0 to 6 years, this is regarded as normal as long as it is not causing the child any pain or discomfort. After the age of 6 if the child continues to have this structure then it is likely hereditary. Flat feet are nothing to worry about unless there is discomfort on the feet.
In-toeing occurs when the feet turn inward while walking, running and standing instead of pointing straight ahead. This can be seen as early as when the child starts to walk. The source of the rotation could be from the foot, shin bone, thigh bone or muscles.
In children under the age of 8 in-toeing is likely to correct itself. If it does not correct itself or causes discomfort then it is important to get children’s foot care advice from a podiatrist and get to the bottom of the problem.
This is the opposite of in-toeing or pigeon-toed walking. Instead of the foot pointing forward as it should, it points to the sides. As with in-toeing, the deformity on the legs may not always be the same and one leg could appear worse than the other. This deformity can be caused by an external rotation of the shin bone or the thigh bone. It can sometimes be associated with family history, foetal position before birth, resting position of the child in infancy and being flat-footed.
Typically, children outgrow an outgoing gait by the age of 6 to 8. You should be cautious if your child complains of pain, discomfort, limping or tripping. Seeing a professional could be the sensible thing to do in those cases.
Typically, curly toes worsen over time and are unlikely to correct themselves. In the long run, curly toes can be a risk factor for corns and calluses or blistering that can cause pain. If your child experiences any of the above-mentioned symptoms due to curly toes then it is important to see a podiatrist. They will look at the cause and may be able to provide little devices that are specially moulded to temporarily help the toes into a better position.
Warts and verrucae are HPV (human papillomavirus) infections of the skin. They could be due to skin-to-skin contact or via contact with a contaminated surface like a communal shower or pool floor.
Warts can be self-limiting or they may persist for long periods of time. The most common warts found on feet are plantar warts which are found on the sole of the foot and mosaic warts-warts which are present in clusters. Other types of foot warts include verruca vulgaris that present with finger-like projections and periungual warts that are found around the nails.
Podiatrists will be able to offer several different chldren’s foot care treatments for warts that are persisting and/or causing discomfort.
Nail and Skin Problems of Feet
Children can present with a myriad of skin and nail problems on their feet. These include but are not limited to ingrown toenails, discoloured toenails, verrucae, skin fungal and bacterial infections, and chilblains. The above listed are present in healthy children although verrucae and fungal skin infections could indicate immunosuppression. Some skin and nail conditions are congenital or due to an underlying disorder. These disorders present differently in individuals.
If your child suffers from a nail or skin condition in their feet, you must tell your healthcare practitioner about any disorders that your child is diagnosed with. This will highly influence the treatment protocol followed. Most nail and skin disorders in children tend to resolve on their own. However, it is recommended to see a professional who will confirm if that is the case.
Ingrown toenails are one of the most common nail conditions that present in children. This happens when a nail grows into the adjacent skin causing a cut in the skin. These can be hereditary, happen when toenails are trimmed too short or due to ill-fitting footwear.
Ingrown toenails are often present in infants and should be addressed straight away. They are not self-limiting so they do not resolve on their own. Trying to self-treat could also push the nail further into the skin causing more pain and swelling. It is advisable to seek medical attention as soon as possible to prevent any further damage.
Sever’s Disease (Heel Pain)
Sever’s disease is commonly seen in active children between the ages of 9 and 12. It is characterised by pain on the back of the heel and can often cause redness around this area. Sever’s disease occurs due to traction of the Achilles tendon on the growth plate where it attaches. This causes repetitive microtrauma which then leads to inflammation and pain.
This disorder is likely to resolve on its own but could cause debilitating pain. There is a range of conservative treatments that can be given to ease the pain. These include taping or strapping, stretching and the use of orthoses. In extreme cases, further investigations need to be made to rule out any cysts, fractures, infections and tumours that could be causing pain.
Osgood-Schlatters (Knee Pain)
Osgood-Schlatters is an uncommon disorder that has a similar cause as Sever’s disease. It is often found in active children and is also due to traction of a bony protrusion called the tibial tuberosity on the front of the leg just below the knee joint. This traction causes microtrauma over that area which then leads to inflammation, swelling, pain and tenderness.
The protrusion could get bigger over time and in 20% of cases it presents on both legs. Just like Sever’s disease, it is self-limiting but it is advisable to consult a healthcare professional to help rule out any differential diagnoses and to confirm it is Osgood-Schlatters.
A sprained ankle occurs when one of the ligaments found on the outside of the foot at the ankle joint is overextended. This can lead to micro tears in the ligament or a complete tear. The severity of the injury is proportional to the force that displaced the ankle.
In children, the cause of ligament injuries is generally related to participation in a high-impact pressure or load activity. It can also be related to excessive weight. The ankle tends to swell up after such an injury. However, if swelling is excessive then it could be that the ligament is completely torn or there is an ankle fracture. After such an injury medical attention should be sought, especially if there is too much swelling.
Different types of heel pain can affect a child’s foot. The diagnosis of your child’s heel pain depends on the part of the heel that is painful, and the signs and symptoms that the child presents with.
Pain on the sole of the heel could be a sign of Plantar Fasciitis or a heel spur. Pain on the back of the heel could be Sever’s disease, Bursitis or Haglund’s deformity. All these disorders can be successfully managed by a podiatrist.
This is a sports injury that often happens in runners. Pain and discomfort occur due to excessive traction of the outside layer of the shin bone (periosteum) or micro-tears on the muscles in your lower leg that are responsible for rolling the foot inward.
If your child is involved in a sport that requires a lot of running and has flat feet/overpronation when they walk they are at risk of getting shin splints. If your child already presents with pain on the inside of the lower third of the front of the leg then they will most likely suffer from a shin splint.
Arch supports could help reduce the pain but if that does not help then seeing a qualified podiatrist is the next step you should take.
Sporting Injuries in Feet
Sports injuries are usually more common in adults but occasionally present in children. As a parent of an active child, it is always safe to pay attention to your growing child’s body. If something looks off then it is much safer to seek professional help. Excessive weight is a risk factor for many sports injuries so that is always a good starting point in preventing sports injuries.
The most common sports injuries are ankle sprains, lower leg fractures, heel pain, knee pain, and muscle strains such as shin splints and tendinopathies.
Symptoms of feet problems in children to look out for
You should see a podiatrist if you are worried about your child’s feet if there is anything abnormal that is present on your child’s feet.
Symptoms to look out for include:
- ingrown toenails/pain and swelling on particularly the big toes, they can occur in the lesser toes as well (that persist or are painful)
- pain while walking
- favouring one leg over another when walking
- severe in-toeing or out-toeing
- not walking by 18 months
- swollen feet
- sores or hard skin on the legs and feet
- excessive wear clearly visible on the outside of the shoe
Ideal footwear styles for children’s foot care:
6 things to look for when choosing children’s shoes
Here are 6 things to consider when purchasing shoes for your child:
- Breathable and flexible material paying attention to any seams in the shoe that could rub on your child’s foot. A developing foot needs space to grow. Breathable shoes allow for proper air circulation in the shoe to prevent excessive sweating and the growth of microorganisms
- Wide and high toe area to accommodate the child’s foot shape. To get the child’s natural foot shape the foot’s length and width should be measured and the measurements should be referred back to when purchasing shoes. Since children go through growth spurts it is advisable that the child’s foot is measured every time shoes are bought.
- High and snug heel cup so that the heel does not constantly come out as the child walks.
- Velcro strap or shoe lace fastening to allow for a snug foot and prevent the shoes from slipping out while your child is walking and running.
- Soft and comfortable insole to prevent any high-pressure areas on the foot and ensure that your child is comfortable walking.
- A bit of thickness on the outer sole to protect your child’s foot when walking on uneven terrain, rocks and sharp objects.
5 Top Tips for Caring for Children’s Feet
- Inspect regularly
- Keep feet clean
- Trim toenails
- Check shoes for unusual wear
- Book a regular foot health check.
Why it is important to have a foot health check for children
There are many signs to look for in a child’s foot that could point towards issues your child is experiencing now and problems they are likely to face later in life. These indicators are not always evident to a layman which is why it is highly recommended to book your child for a foot health check.
Extreme deformity and pain are signs that you should book your child with a healthcare professional such as a podiatrist. A foot health check is important to tackle any issues as early as possible to ensure a good prognosis. If your child has a problem that is not investigated at its initial stages it could progress into something more severe.
How Randell’s Footcare podiatrists help with children’s foot care
Randell’s Footcare has HCPC-registered podiatrists who are experienced and qualified in treating children and their foot problems.
They can advise and support parents who are worried that their child may have a foot issue or that their child’s foot development falls within acceptable limits for their age. Our expert podiatrists will assess your child’s foot and offer advice and discuss treatment options if needed.
Book an appointment for children’s foot care
Call us on 01603 737 188 or book online to arrange a podiatry appointment for your child to check their foot health or assess their foot problem or development.