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Common Foot Problems In Children (Part 2)

kids feetLast week we looked at a few of the common conditions we see with children’s feet.  Today we will look at the rest of that list:


Warts are hard and often painful lesions usually on the bottom of the feet.  They can appear raised or relatively flat, and will often have a cauliflower-like pattern with black speckles.  Caused by a virus and spread by contact with skin tissue containing the virus, this condition may or may not be painful and can easily spread around the foot and to other family members.  Common areas of infection include bathrooms, showers, and locker rooms.  Unlike warts on the hands, over-the-counter medications are usually ineffective.  Treatment takes time and patience.

The most consistent and effective treatment involves removing the superficial hard skin every couple of weeks and applying a chemical to irritate the skin surface.  In time, this will attract the body’s immune system which will create an antibody to the virus and destroy it.  Ultimately, one will be immune to the virus strain after that.  Although there are over fifty different strains of virus that can cause warts and reinfection by a different strain is possible, it is not common to encounter the virus and most kids stay uninfected.  Surgery can be considered to remove the wart, however, this is usually reserved for painful warts not responding to chemical treatment as no immunity is achieved in surgical treatment.

Flat Feet

Flat feet are usually the result of one’s own genetics inherit from their family.  Flattening is a normal part of the walking cycle of the foot.  However, in some individuals the foot flattens too much.  This changes the way certain muscles in the foot and leg have to function, which causes numerous changes to the feet over time.  Some people may live their entire lives without having any problems, which some people may have pain starting in childhood.  Young children tend to have flexible, flat feet from which they usually develop normal arches before they reach school age.  Because of the extra demand on foot muscles, people with flat feet become fatigued easier , with leg pain or cramping after activity.  A common complaint of children with flat feet is pain in the shins at night.

Severely flattened feet many cause hip, knee or back misalignment.  Individuals with flat feet may develop bunions and hammertoes over time, and are eventually more susceptible to injuring their heel.  In the most severe cases, early arthritis may develop in a number of joints in the feet.  For most kids, treatment with prescription shoe inserts (orthotics) is generally successful.  Orthotics realign the foot to allow it to function properly.  This helps to reduce much of the pain associated with flat feet, and will help prevent further progression of associated problems like bunions and hammertoes later in life.  Properly supportive shoes are also a necessity.  Unfortunately, severe cases require surgery to reform the foot into a more functional shape.


Sprains are common in kids, and usually involve the ankle or big toe joint.  Recess activities, sports, and active play can cause sprains.  These generally heal on their own, and usually only need icing, rest, and support.  Sprains that are severe, on which the child cannot bear weight, or minor sprains that do not heal in 2 weeks need to be evaluated.  Any suspected fracture, even of a big toe, needs to be evaluated as a growth plate can be affected.


Bunions are a complex foot deformity of both bone and soft tissue.  Usually inherited from one’s parents or grandparents, bunions can have several underlying causes.  The most common cause is flat feet.  Over time,  muscular changes needed to adapt to waling with flat feet will contract the big toe towards the second toe, and make the prominent 1st metatarsal head (bone) on the inside of the foot.  This can create pain in the bunion when rubbed against tight shoes.  Joint pain in the big toe can develop over time due to its abnormal position and eventual onset of arthritis later in life.  The big toe can also crowd into the lesser toes.  This condition is often seen in hammertoes.

Treatment can include conservative measures that attempt to pad the bump or separate the big toe from the second toe.  Wider shoes may also help relieve the bump pain.  Orthotics may help lessen the progression of the bunion by controlling the underlying cause (usually flat feet).  However, in most cases, surgical correction with correction of the bone position and soft tissue contracture is necessary to permanently treat this condition.  This is only necessary in kids if the pain is severe, or if the deformity is limiting activity.  Otherwise, surgery can wait until the teen years when the bones have little growth left.

Once again, prompt evaluation and treatment of foot pain is the key to preventing future problems.  Well fitting and comfortable shoes go a long way to keep children’s feet safe and active.  Keep in mind that no amount of foot pain is ‘normal’, and its presence should not be brushed off as a ‘growing pain’.  If this is the case with your child, make an appointment to come into the clinic for an assessment to put your mind at ease.IMG_1546

Thanks for reading,



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Sutherland, NSW 2232

Tel: 02 9542 3491