Podiatry for children
Here at Blueprint Podiatry, we enjoy helping children of all ages, with heel pain to stay active, healthy and happy.
Here at Blueprint Podiatry, we enjoy helping children of all ages, with heel pain to stay active, healthy and happy.
Your child depends on having pain free, healthy feet, to ensure they stay active and don’t refrain from day-to-day activities and exercise. It is best to have your child’s feet checked to ensure small problems don’t turn into big ones. Our team take a gentle approach, as we want to ensure both parents and children feel comfortable and cared for.
To book an appointment for your child, please contact us or book online today!
Common foot conditions in children
Ankles, Legs, Hips and Knees
Pain in any area of a child’s body – foot, ankle, legs, knees or hips isn’t normal and should be assessed. Foot alignment and mechanics have an influence on how well the rest of the leg and the main joints, the ankles, knees and hips are aligned and function. The feet really are the foundation of the body and need to be well aligned and functioning in a stable way. One sided pain may indicate a leg length discrepancy or relate back to a previous injury. Children have active lives and are often playing all sorts of different sports or involved in dance or gymnastics. Sometimes poor footwear is a contributing factor also. Podiatrists at Blueprint Podiatry are experienced in assessing children’s feet and their whole body posture and importantly providing advice and treatment options that look at all of these factors.
Autism is generally characterised by difficulty communicating and developing relationships with other people through language and abstract concepts and will typically present in early childhood. It has also been found that children with Autism may have difficulty in performing and developing gross motor skills, coordination and balance which are all factors that contribute to gait patterns.
Other factors effecting the gait are delayed or atypical motor developments, low muscle tone (hypotonia), poor balance, coordination, joint proprioception and an awkward gait pattern.
Orthotic therapy and footwear advice may help. It is common for children with autism to toe walk and have sensitive sensory which may effect the wearing of socks and walking bare foot on certain surfaces.
Blisters are a small sac of fluid that form under the skin over areas of friction. They can be superficial or form in deeper layers of skin below areas of callus. Sweaty skin is more prone to blisters and treating that can help. Blisters are common with children due to sweaty feet and often due to wearing in new shoes.
We recommend keeping a blister intact to avoid breaking the skin and risking infection however your podiatrist may need to drain a blister to relieve pain in some cases.
Your podiatrist will discuss preventative measures and also look at your foot mechanics to give advice regarding pressure or fiction areas on your feet.
Bunions are the actual boney lump that gradually form over the inside of the big toe joint – Hallux Abducto-Valgus or HAV is the technical term that describes how the big toe changes direction and rotates due to pressure and mechanical forces at the joint during gait. Certain foot types can be more prone to HAV and bunion formation and are often hereditary.
Poor foot mechanics play a big part where excessive pressure results at the big to during gait. Footwear – in particular narrow toed and high heeled shoes and some activities such as sport an ballet are also contributing factors. Some bunions are pain free others are painful due to several factors – corns on the bunion, rubbing on shoes, bursitis formation at the joint, limited movement of the joint and are at greater risk of arthritis.
Your podiatrist can help treat symptoms and advise you on footwear, and assess your foot mechanics and recommend orthotic options to reduce the pressure at the big toe joint and slow the process down. Most bunions start forming during adulthood – Children can develop Juvenile Bunions from the age of 10-15 in these cases there is a strong genetic component.
At Blueprint Podiatry we are experienced in assessing foot types prone to bunions and can advise on orthotic therapy to slow down this process especially when we are assessing and working with children. In some cases we will discuss surgical options and refer to a podiatry surgeon for a surgical opinion
Cerebral Palsy occurs due to an impaired muscle coordination known as spastic paralysis and other disabilities, which have been caused by damage to the brain before or at birth. Spasticity occurs as a result of increased muscle tone, which results in muscle stiffness. This muscle tightness makes movements difficult and can effect posture and balance. Toe walking is a common issue also. Podiatry can help with pressure areas, orthoses and footwear.
Some children are born with curly toes – commonly one or both of the 4th toes. This can be genetic, or due to a longer toe that curls under the toe next to it which is usually more noticeable when a child starts to walk. In most cases curly toes from birth are not a problem but may require some monitoring with your podiatrist as your child begins walking and wearing shoes. If this condition appears to worsen with walking and the toes appear to be gripping this may be contributed to by foot alignment and mechanics and may require further treatment. Sometimes simple strapping techniques can help improve toe alignment in young children.
Dermatitis and Excema
Dermatitis/Excema are a group of diseases that result in inflammation of the skin. There are various conditions that cause dermatitis including as a result of allergies, irritants, and poor venous circulation, some causes are unknown. Many people suffer from some form of dermatitis which often begins in childhood. Some symptoms include blisters or dryness and thickened skin. At our clinic we can offer advice including natural remedies to help with these symptoms.
Diabetes Mellitis is a group of metabolic disorders where there is a high blood sugar level in the body.
Type 1 involves the pancreas not producing enough insulin and usually occurs in younger people including children (juvenile diabetes) .
Type 2 involves the body resisting insulin and is more likely to occur in middle to older adults as a result of poor diet and excess weight and lack of exercise.
Gestational Diabetes is a third type that can occur in pregnant woman with no prior history and often resolves post-natally.
Diabetes is a complex disorder and complications can effect the circulatory and neurological systems which can have a big impact on the feet. A gradual loss of sensation and or circulation in the feet can cause problems with wound healing, injury to the skin due to lack of feeling, balance and motion, and the general health of the skin and nails. Foot health and regular monitoring is essential for diabetics including a diabetic foot assessment conducted annually and more frequently in high risk cases.
Your podiatrist understands the effects of diabetes and can provide treatment and preventative advice for the feet. Diabetics are eligible for Medicare EPC rebates for Podiatry – please see your GP for a referral and care plan.
Flat Feet, Pronated Feet, Rolled in Feet
Flat feet or Pronated Feet or Rolled in Feet usually have quite flexible joints and the range of motion to roll in or collapse through the arches. In children under the age of 2 years it is normal to have flat chubby feet but by 2 years of age some development of an arch should be visible.
This foot type in children often requires more muscle energy is required than normal during gait to maintain unstable joints thus resulting in fatigue or tired aching feet and legs, so the children who don’t want to walk far or want to be carried. Pronated feet or rolled in feet do not necessary always result in a lowered or flat arch. Pronation is the motion of the joints in the rear foot that control to some degree how the whole foot operates.
Feet that pronate during gait appear to be rolled in at the heels and medial ankle and sometimes have a lowered arch but not always, and there is excessive pressure under the ball of the big toes when stepping forward. Pronation at the foot can also result in internal rotation at the legs and knees. There are many symptoms or foot conditions that can be as a result or contributed to by pronated feet and your podiatrist can assess and explain how your child’s feet function and the related issues and then advise on the best treatment plan to suit your child’s feet. Orthotic therapy is often indicated with flat feet, pronated or rolled in feet.
Pronated feet don’t always present with pain especially with children however a range of potential issues related to pronated feet may occur at some stage and our experienced Podiatrists are able to advice you on preventative orthotic therapy related to your child’s feet also considering their hereditary history and activities including sports and dance.
Functional Leg Length Difference
In most cases LLD is functional and as a result of a tight joint or muscles on one side of the body – often the hip or a pelvic imbalance. Many things can cause this to happen such as activities at work that require standing and twisting in one direction, or sports such as soccer and football where one side of the body is used differently to the other. Functional LLD often results in the feet compensating for the imbalance and one foot functions differently to the other which over time can cause pain in one foot. A functional LLD can usually be resolved by working on the tight joint or muscles and re-balancing the area with stretches. Unstable foot mechanics can also contribute to pelvic imbalances so several components need to be assessed and treated.
At Blueprint Podiatry we work closely with Paediatric Physios and Osteopaths to align the whole body and resolve a functional LLD before working with orthotic therapy, and in our experience working on the whole body’s alignment from the feet up gets the best long term results
‘Growing Pains’ are commonly described in children as painful muscles in the legs usually over night but also used to describe all sorts of pains in the limbs. Although there is no known cause other than a possible link with growth spurts – our experience as Podiatrists and in working with children for many years suggests that there is quite often an underlying mechanical issue with the feet and legs which results in tired aching legs at the end of a child’s day full of activities, which may be exacerbated during times of growth.
Some children seem to be more sensitive to pain also. We have found that orthotic therapy combined with Paediatric physio and Osteopathic treatment where indicated works in most cases to ease tired aching legs and night pain that wakes children up. A full biomechanical and gait assessment is important for us to give advice on the best treatment plan.
Hypermobility is a common condition for children where joints move through their range of motion more easily and beyond the normal range. There is a genetic factor with hypermobility and other causes may include abnormally shaped joints, abnormal joint proprioception and in some cases children may develop Hypermobility Syndrome or other collegen or connective tissues disorders such as Elhers-Danlos Syndrome.
Children may experience joint or muscle pain, higher risk of frequent sprains and injuries, ligament laxity and spine scoliosis. Orthoses and supportive footwear are usually recommended by your podiatrist other treatment may include strengthening exercise and activities and strapping.
In-toeing or Pigeon Toes
Children with this complaint walk with their feet/toes turning in – they are usually not in any pain unless they also have very pronated feet which may cause leg tiredness or knee pain – but may be at higher risk of tripping and as a result injuring themselves. In-toeing can be a complex issue and can be caused by 3 main factors – Metatarsus Adductus (turned in foot/big toe), Tibial Torsion (shinbone/leg turns inwards) or Femoral Anteversion (Thigh bone turns in).
There is often a genetic component and the hip position can also influence the position of the leg and foot. Hip, leg and foot positions can be influenced in the womb usually if there is not enough room or the feet or legs are squashed into certain positions. In-toeing is usually first noticed when children begin walking and is most common in children under 8 years, but can also spontaneously appear at any age during childhood. It can effect one or both feet/legs/hips.
Treating in-toeing usually involves advice re footwear, gait exercises and in some cases orthoses. At Blueprint Podiatry we work closely with other practitioners often Paediatric Physios and Osteopaths to assess and treat the hip and leg position and re-balance muscles and gait patterns. In-toeing can be complex to manage and often involves other issues such as pronated or flat feet and your Podiatrist will explain and discuss your child’s conditions and treatment options in detail.
Ingrown Toenails occur for all ages sometimes even at birth, and common in age 12 to teenage years. This age group are usually attending to their own nails – but may not always be cutting them correctly and and parents aren’t always aware of the issues initially. Sweaty feet can contribute to the tendency for the nails to grow in. Ingrown nails are most commonly the big toenails but can occur at any nail and result from a nail spike growing into the flesh of the toe. They are very painful often appear red and inflamed and weepy with pus. If left untreated they can become infected and require antibiotics. They are often caused by not cutting the nail properly, poor fitting shoes or simply the shape of the toenail.
Bunions are the actual boney lump that gradually form over the inside of the big toe joint – Hallux Abducto-Valgus or HAV is the term that describes how the big toe changes direction and rotates due to pressure and mechanical forces at the joint during gait. Certain foot types can be more prone to HAV and bunion formation and are often hereditary. Poor foot mechanics play a big part where excessive pressure results at the big to during gait. Certain activities such as soccer and football and ballet are also contributing factors. Children can develop Juvenile Bunions from the age of 10-15 in these cases there is a strong genetic component. At Blueprint Podiatry we are experienced in assessing foot types prone to bunions and can advise on orthotic therapy to slow down this process especially when we are assessing and working with children.
Diabetes Mellitis is a group of metabolic disorders where there is a high blood sugar level in the body. Type 1 involves the pancreas not producing enough insulin and usually occurs in children. Children and adults with Type 1 diabetes need treatment with insulin to survive. Long term complications of this form of diabetes can effect the circulation and neurological systems in particular to the feet. Monitoring and understanding foot health and diabetes is a good habit to get children into to help prevent complications later on such as poor wound healing, ulceration and numbness.
Knock Knees- Genu Valgum
Genu Valgum commonly known as knocked knees, is a condition in which the knees roll in and touch each other when the legs are straightened and when standing. In some cases children are unable to stand with their feet together due to the angle of the knees. This condition is most common in 2-5 year olds. Pronated or rolled in feet are usually an underlying contributing factor that influence the angle the knees can operate on. Children in general often have quite flexible joints – and those with genu valgum can be quite hyper-mobile in their joints which encourages feet and knees to roll in. Orthotic therapy is usually indicated to help align the feet and knees along with advice on supportive footwear.
Leg Length Difference
A Leg Length Difference means you have one leg longer or shorter than the other and is quite common in both adults and children. LLD can be structural or functional – see below for both types.
Signs to look for for both types of LLD – one foot rolling in or one foot rolling out more than the other, uneven wear patterns on shoes and one sided pain in the foot, ankle knee or hip. A full assessment with your podiatrist will determine the type and likely cause allowing them to discuss your best treatment options.
Metatarsus Adductus is a condition where the foot turns in from the middle of the foot to the toes – the big toes commonly adduct and create a gap between the 1st and 2nd toes. It is common in children under 2 years of age and one of the causes of an intoeing gait. For children under 2 this condition can be helped with strapping and padding in shoes, and for older children orthoses may be indicated.
In Osgood-Schlatter disease, children have pain at the front of the knee due to inflammation of the growth plate at the upper end of the tibia (shinbone). The boney bump at the top of the shin where the knee cap tendon attaches gets inflamed and can become enlarged. This condition is common in active children playing a lot of sport and triggered by a growth spurt.
Treatment includes rest, strapping and foot wear advice . Underlying foot mechanics may need to be assessed and treated with orthoses if knee alignment is contributing and a referral for Paediatric Physio and Osteopathic treatment on the knee is common advice also.
Severs Disease is one of most common causes of heel pain in children, often occurring during adolescence when children hit a growth spurt. During growth spurts the bones sometimes grow a little quicker than the tendons which creates strain on tendons and pain where they attach to the bone. Also known as an osteochondrosis or apophysitis, Sever’s disease is an inflammatory condition of the growth plate in the heel bone (calcaneus).
Children usually complain of pain in the achilles tendon also. It is a common condition amongst children who play a lot of sport. Treatment includes rest from sport, strapping, calf stretches, heel pads/lifts, orthotic therapy and foot wear advice.
Structural Leg Length Difference
Structural LLD is less common and results from an actual difference in the bony length of one leg to the other. This can develop from differing growth rates as a child, sometimes due to disease or treatments such as chemotheray that interfere with bone growth plates, injuries and surgery to a bone or joint can result in a change in the length.
Sometimes other factors including scoliosis of the spine or damage to spinal discs that alter the alignment of the pelvis result in an imbalance that creates one shorter leg on standing. A structural LLD often does require a full foot lift to even up the body and reduce the compensatory changes in the feet and body that often can cause pain.
Sweaty Feet can be caused by a number of issues from sweat gland disorders to exacerbation due to synthetic socks and footwear. Sweaty skin can be at higher risk of blisters, and in some cases bacteria infection which causes a strong odour. Children often have sweaty feet – making sure socks are made from natural fibres helps to minimise this and spending time in bare feet when practical. There are treatment options depending on the severity and these can be discussed along with preventative tips with your podiatrist.
Tinea – also known as Athletes Foot, is a fungal skin infection that effects the feet. It can appear between the toes where there is too much moisture with redness itchiness and fissuring. It also occurs anywhere on the feet and often on the plantar surfaces and symptoms include dryness and peeling skin, redness and itchiness, small blisters with fluid may appear also. There are many treatments available for tinea and your podiatrist can discuss what will work best for you and advise on preventative tips such as choice of socks and footwear. Tinea effects feet of all ages and can be common in teenagers with sweaty feet combined with at times poor hygiene. Our clinic also offers chemical free treatments options for children.
Tired Aching Legs and Clumsiness
Tired Aching legs and Clumsiness – children may complain about tired aching legs and asked to be carried not wanting to walk too far. This may be a result of over working muscles that fatigue quicker than normal. Muscles in the foot and leg have to work hard if the feet are flat or rolling in too much.
Clumsiness can also be a symptom of fatiguing muscles and joints that are out of alignment. A foot and gait assessment of your child will allow your podiatrist to assess their mechanics and advise if orthotic therapy may help.
Tired legs and cramping
Tired legs are often an indication that the muscles of the leg are being overused often due to poor foot alignment and mechanics. Children with poor foot and leg alignment often complain of tired legs and want to be carried after a certain distance of walking.
A full biomechanical assessment and gait analysis allows your podiatrist to determine if leg muscle overuse is linked to the foot mechanics and alignment and the best treatment plan from there. Muscle cramps can be caused by a number of issues including muscles over use, mineral deficiency or poor blood circulation to the muscle.
If muscle cramps occur during walking it may indicate a lack of blood supply and you should see your GP as soon as you can.
Toe Walking is the tendancy to walk on the toes without placing the heel to the ground and is commonly seen in toddlers. There are a range of factors that cause toe walking including short achilles tendons, muscle spasticity, habitual patterns (no known cause) and is often associated with conditions such as cerebral palsy and autism.
Long term toe walking can result in calf muscle shortening, have an effect on the posture – toe walkers often lean forward creating tight muscles in the pelvis and hips, and there can be issue getting used to wearing shoes. Adaptions to shoes and orthotic therapy may be indicated and working closely with Paediatric Physio and Osteopath to release and stretch tight muscles in the leg and pelvis is often important.
Depending on the age of the child night splints are another treatment option that may help.
Warts – also known as Veruca Pedis, Plantar warts and Papillomas, are a living growth caused by the Human Papilloma Virus (HPV). Warts can appear anywhere on the feet and are usually cauliflower like in appearance and painful to squeeze. If over a weight baring area they become quite flat and are pushed back into the skin which often causes pain to walk. Children seem to be quite prone to catching warts and we usually see more children for treatment of warts over the summer months especially at school swimming time. Warts are contagious and often caught in public pools and showers so make sure you wear thongs at all times at these venues. There are several treatment options for warts which will be discussed with you by your podiatrist – at our clinic we offer pain and chemical free treatment options for children.