The Importance of Healthy Feet
When you go into the doctor's office for a checkup of any kind, the first thing they tell you is to take off everything but your socks. So how then, wonders Michael King, D.P.M., a podiatrist in Fall River, Mass., can they check to make sure there's nothing wrong with your feet?
Good question. In fact, foot health in kids of all ages is sorely neglected unless the problem becomes so severe that the child limps or complains of pain. This can lead to all sorts of little problems that can turn into big ones if not caught early.
Unfortunately, I'm an accidental expert on the topic of foot health because I'm from a family with notoriously bad feet. From bunions (mine) to warts (my daughter's) to the nasty fungus my son regularly brings home from Boy Scout camp, we've seen it all. It's all made me a bit of a fanatic about taking a good look at my kids' feet every month or so. It's also led me to think that maybe other parents need a bit of a foot health primer, so below are some common foot problems in children and how they should be treated.
Keeping an Eye on the Feet
James Thomas, D.P.M, of the University of Alabama Birmingham, says that most serious foot problems are caught fairly quickly after a baby is born. "The really bad things congenitally are picked up almost immediately, so where the parents become important in diagnosing foot problems is when the child is at least 3 or 4 years old," he says. "Up to about age 4, kids just pick their feet up and put them down. Around age 4 is when they develop a heel/toe gait. This is when foot problems can begin to manifest themselves."
Thomas says to look for the following:
- A child not participating at the level that is normal for their age or grade range because their legs get tired
- Any discrepancy between the feet, such as one foot turning out more than the other or one foot flatter than the other
While the parent needs to start being vigilant when the child is about 4 years old, that doesn't mean that foot problems can't occur or start beyond that point. Here is a list of common foot problems that can occur through adolescence.
Thomas co-authored a study recommending new clinical practice guidelines for diagnosis and treatment of pediatric flatfoot. Usually, he says, flatfoot – also known as flexible flatfoot – isn't a problem and often resolves itself by age 10 or 12. However, it should be evaluated and monitored both to be sure it resolves itself and to be sure that it is not causing the child any foot or leg pain or causing the child to adjust his gait, which can lead to other problems. Treatment is usually pretty simple and is merely a question of the proper arch support, unless it does not resolve itself. In the latter case, surgery may be indicated.
Also referred to as Sever's Disease, heel pain is very common in children aged 8 to 12. King says they see more and more of this condition now that it's become common for children to do a sport 12 months of the year. Depending upon the severity, a hiatus from sports may be necessary to give it a rest. This is most commonly seen in boys, but as girls become more active in athletics, they are also presenting with more foot problems. King also points out that the habit of putting one's shoes on without untying them is stressful for the foot and heel and should be avoided.
As the term "coalition" implies, this is when two or more bones in the foot are joined. The condition presents as a flatfoot, but usually just on one side and the foot is rigid rather than flexible. This is most commonly seen from age 8 through the teen years. It's a more serious situation than the traditional flatfoot, and can alter the way a child walks and can lead to stiffening of the foot, difficulties in gait and early arthritis.
When I was a kid this was referred to as being "pigeon toed," and my baby brother (now 35!) was in braces from age 3 to 5 to "cure" his pigeon toes. Nowadays, says Thomas, they don't do much bracing, as in-toeing generally resolves itself between ages 7 and 14. Besides, he notes, some of the best athletes in the world are a little pigeon toed, so maybe it's a good thing.
More commonly known as smelly feet, this is not a hygiene issue, according to King. It's merely that some people's feet sweat more than others, and that perspiration causes them to stink. Controls include changing socks more frequently and using an antiperspirant on the feet. If that doesn't do it, there's a stronger medication that a podiatrist can prescribe. It's important to treat this condition, because it can lead to other problems from the constant moisture, including the next two.
Warts are very common in adolescence, especially in those with hyperhidrosis. King estimates that 90 percent of kids with warts also have hyperhidrosis. Warts can be difficult to get rid of because they are caused by a virus. They can be painful if they are on a weight-bearing surface. They can also get too near a nerve and cause pain. My daughter had to have foot surgery to have a stubborn one removed that was causing her extreme pain. Normally, the warts are "burned" off with a topical acid that can be purchased over the counter. If warts persist, see a professional.
Again, hyperhidrosis can exacerbate this, but my son probably picked it up in the communal shower at Boy Scout camp. King suggests that any child in a camp or communal living arrangement wear flip flops in the shower. As for treatment, there are a number of over-the-counter treatments for athlete's foot. If it doesn't clear up, see a doctor.
King says this can be serious if left untreated because it can become infected, and a big cause of infection in teenagers and adults is bathroom surgery. In other words, when they try to dig out an ingrown toenail, it becomes infected. In a case where a child is also diabetic, this can be a disaster. A professional foot doctor not only can clear up infection, but can fix the underlying cause of ingrown toenails, especially if it's a recurring problem.
You might not think about your child's foot health on a regular basis, but it's never too late to start. Think about how much your child depends on his feet to get him where he's going. When you do, it's easy to see how taking good care of the feet now can only help your child out later.