The summer has flown by and once again thoughts are turning to school and to the children going back into regular shoes.
This is a good time for parents to evaluate the children’s foot care needs and to try to prevent problems from developing.
Warts are hard and painful lesions which usually appear on the bottom of the feet. They can appear raised or relatively flat and will often have a cauliflower-like pattern with black speckles. These lesions are caused by a virus which can spread upon contact.
Children walk barefooted around pools and in playgrounds during the summer and this can be a source of contamination. Other places the wart virus can be transmitted from one person to another are
bathrooms, showers and locker rooms. Unlike warts on the hands, over-the-counter medications are usually ineffective.
Treatment options include the removal of the hard skin and the application of chemical or cryotherapy modalities. Surgical excision of the wart is reserved for painful warts which do not respond to other treatment modalities.
Ingrown nails are another common problem seen in children. Repetitive injuries to the toe, such as heavy objects falling and hitting the toe, pressure from poorly fitted shoes, nail fungus or bruising the toe while engaged in athletics may cause changes to the nail matrix. In time the nail may abnormally grow inward. Another common causative factor is poor nail trimming which may leave a spike of nail that can protrude into the skin as the nail grows outward. It is important not to trim the nails too short and to cut them straight across. Young children often cause ingrown nails by picking at their nails.
Once the nail becomes ingrown, home based “bathroom surgery” is not recommended as this may significantly worsen the condition. It is important to address the ingrown nail and have it professionally treated as the offending nail border needs to be removed before the infection may spread to the underlying bone.
Flat feet are usually the result of one’s genetics. It is normal to have flattening of the foot while walking. Young children tend to have flexible, flat feet as a normal finding and they usually develop normal arches before they reach school age. However, if the child’s feet do not develop the normal arches, the foot and leg muscles have to accommodate the flat feet and the extra demand on the foot and leg muscles can cause fatigue, leg pain or cramping and pain in the shins at night.
Hip, knee and/or back malalignment can result as can the development of bunions and hammertoes. Orthotics are the treatment of choice for most children. Orthotics realign the foot to allow it to function properly. The orthotic devices should be custom-made for the child to maximize the correction and help prevent other problems from developing.
Heel pain is another common condition in children. Most often, in children, heel pain is caused by inflammation in a growth plate on the back of the heel bone. The pain is located on the back or the bottom of the heel and is present with increased activity, or even standing and walking. Other causes of heel pain can include stress to a ligament called the plantar fascia. 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.
The podiatrist has many treatment options for this condition and professional evaluation is imperative as systemic diseases like juvenile rheumatoid arthritis have to be eliminated.
Children are important patients as we realize the importance of early intervention to help prevent the development of serious foot deformities. Active children are happy children and no child can enjoy physical activities if there is foot