Updates of whats up in Podiatry

Fitting Children’s Shoes

Parents so often worry about their kid’s teeth, eyes, and most other areas of the body, but do not get worried so much over the developing feet. Plenty of adult foot conditions can have their beginnings in childhood, consideration to footwear in kids can minimize the risk of these issues in adults.

Significance of the shoe to the child:
Inadequately fitting children’s shoes can cause many conditions in adults such as hammer toes, ingrown toenails, foot corns, calluses and bunions. Considering the high level of pain and discomfort that these disorders can cause, it is obviously logical to attempt to prevent these disorders by making certain that the child’s shoe is fitted correctly. Foot conditions in children are usually preventable.

Fitting footwear for the child:
The most important factor in shoes for a child is that they fit. Preferably, this means that footwear is fitted by somebody who has had some special education in the fitting of children’s footwear.

Tips for the fitting of children’s footwear:
* Children should have their feet measured roughly every three months (thus ensuring the need for new footwear as required).
* Typically, for a shoe to be correctly fitted, there should be a thumb width between the end of the shoe and the end of the longest toe.
* When looking at the bottom (sole) of the footwear, it should be fairly straight (not curved in too much) – feet are straight, so the footwear should be straight.
* The fastening system (laces, velcro, buckles) need to hold the heel securely in the back of the shoe (the foot ought not to be able to slip forward in the shoe).
* the heel counter (back part of the shoe) should be strong and stable.
* the footwear ought to be flexible across the ball of the foot, since this is where the foot bends.
* Leather and canvas are a better material – these are more robust and can breathe. Artificial materials usually do not breathe as well, except if they are of the ‘open weave’ type. Avoid plastics.
* Make certain the footwear have curved toe boxes to allow the toes more room to move and grow.
* Shoes ought not have to be “broken in”. Should they do, they are either improperly designed or badly fitted.
* An absorbent insole is useful, as the feet can sweat a great deal – children are very active!
* A number of stores focus on shoes for the child – make use of them!
* Fitting shoes correctly in adults is also just as crucial

3 tips for examining the child’s footwear:
There ought to be a thumb width between the end of the shoe and the end of the longest toe = length is correct.
You ought to be able to pinch the upper of the footwear between your thumb and forefinger (this can depend on the character of the material) = width is proper.
Does the shoe fit snugly around the heel and arch? How stable is the footwear when trying to ‘pull off’ the footwear? = good fit.

February 8, 2021 Posted by | Footwear | | Comments Off on Fitting Children’s Shoes

Calcaneal Apophysitis

Calcaneal Apophysitis is the technical name for severs disease. This is an injury or inflammation to the back of the heel bone in growing kids. The classic symptom is pain on squeezing the sides of the heel bone. The pain is usually present with activity and can limit sports participation.

This video from PodChatLive is an in-depth look into calcaneal apophysitis.

The standard treatment for this condition is to use a heel raise to lesson the pull from the achilles tendon and cushion the impacts with the ground. A reduction is sports activity is often needed. If none of these treatments help, then calcaneal apophysitis should be placed in a walking cast.

December 12, 2012 Posted by | Foot Problems | , | Comments Off on Calcaneal Apophysitis

Toe Walking

A lot of kid like to walk on their toes. They do so to make themselves taller. Generally it is off no consequences and they get over it. However, toe walking can also be due to a more serious problem so each case of toe walking does need to be taken seriously.

Toe walking is common in conditions like autism and cerebral palsy, but a number of other developmental and behavior problems can underpin it. If the child can get the heel to the ground easily and all the usual developmental milestones are reached, then the chances are that the toe walking is not a problem.

November 18, 2012 Posted by | Foot Problems | , | Comments Off on Toe Walking

Severs Disease

The most cause of heel pain in children is a condition known as Severs disease. The most common cause of pain is squeezing the sides of the heel near the posterior aspect. The pain is located in the bone and not in the joints and not in the tendon. It is usually only painful on activity and not at rest unless it has got really bad. There is debate if it should be called Severs disease or calcaneal apophysitis.

The standard treatment is lots of stretching of the calf muscles and a heel raise. A gel heel raise is commonly used for this. It is also common to reduce activity levels to help. Later a complete abstinence from sport may be needed if they the initial treatment does not help.

November 4, 2012 Posted by | Foot Problems | , | Comments Off on Severs Disease

Growing Pains in Children

This is a really common problem and not a lot is really known about it. The classic symptoms are pain behind the knee that only occurs at night. generally it will wake the child from sleep and be distressing foe the child and parent. There are a number of rare conditions like bone tumors and juvenile arthritis that need to be ruled out as causing the pain, which is why the symptoms have to be taken seriously. The condition is self limiting and reassurance is all that is needed.

There is a paucity of research on growing pains with lots of opinions and ‘old wives tales’ on how to manage it. Most of these do seem to help in a lot of cases.

October 13, 2012 Posted by | Foot Problems | , | Comments Off on Growing Pains in Children

Kohlers Disease

This is an uncommon problem of the tarsal navicular bone, but I have seen 3 in the last 2 weeks! They were all in 5-6 year old boys. They all caused the child to limp and all were really poor at telling me where it hurts, which is pretty typical for this age. Once the pain was located to the bone, it was clear what this probably was and the x-rays confirmed it. In each case the navicular on the affected side was ‘squashed’ compared to the other foot (see these x-rays). I put all 3 into walking braces to protect the foot. Will report back how they did.

September 1, 2012 Posted by | Foot Problems | | Comments Off on Kohlers Disease