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Common Foot Problems in Children (Part 1)


Children have their share of foot pain, just like adults.  Many conditions that cause adult pain can also cause pain in children.  At times, there are conditions unique to children that are the source of their pain.  Prompt recognition and treatment is important for foot problems in children, as some conditions can have long reaching complications into adulthood.

Heel Pain

Heel pain is caused by many different conditions.  The most common heel pain found in kids is caused by inflammation in a growth plate on the back of the heel bone, irritated by the Achilles tendon.  The pain is located on the back or the bottom of the heel and is present with increased activity, or even standing or walking.  This pain typically occurs in kids from age 10 until the early teen years when the growth plate ‘closes’, or stops growing.  It will generally resolve on its own, but help is needed to accelerate the process.  This can include temporary activity/sports cessation, icing, anti-inflammatory medications, stretching, and heel lifts or cups.

X-rays are needed to rule out fracture, which, though rare, is possible.  Other causes of heel pain can include stress to a ligament like structure under the foot called the plantar fascia, seen in kids with flat feet and high arches.  This pain is usually located on the heel near the arch, and is worse after getting out of bed and at the end of the day.  Treatment requires stretching, icing, anti-inflammatory medication, and prescription orthotics to control the underlying structural problem (support for flat feet and shock absorption for high arches).  Less commonly seen causes of heel pain can include foot symptoms of systemic diseases like juvenile rheumatoid arthritis.  The underlying condition needs to be addressed to fully treat the foot in these instances.

Ingrown Toenails

Ingrown nails may be present in any toe and at any age.  Ingrown nails may be inherited, and may also be seen later in life due to gradual damage to the cells under the skin that grow the nail (nail matrix).  Repetitive injuries to the toe, such as heavy objects falling, pressure from poorly fitting shoes, nail fungus, or toe bruising (common in athletes) may cause irreversible changes to the nail matrix.  In time, the nail may abnormally grow inward due to these changes.  Regardless of its cause, an ingrown nail will cause pain and inflammation to the skin along side it, and eventually infection will develop.  If untreated, the infection may spread and may eventually involve the toe bone underneath.

Temporary treatment may consist of regular soaking in warm, salt water, application of betadine, and the use of an antibiotic medication to control the infection.  The offending nail border must be removed to resolve the condition.  This is accomplished through a short office procedure where the nail border is removed under local anaesthesia and a mild acid is used to prevent the nail matrix from ever growing the nail back into the skin.  Home based ‘bathroom surgery’ is not recommended as this may significantly worsen the condition.IMG_1546

Next week I will discuss 4 other common foot problems with children’s feet.

Thanks for reading,



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Sutherland, NSW 2232

Tel: 02 9542 3491