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4 Common Pediatric Foot Problems

Conditions that Often Affect Children's Feet

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Updated May 02, 2012

Children are affected by many of the same foot conditions that adults are, including plantar warts, flat feet, heel pain, and ingrown toenails. Some of these conditions take on different characteristics or may occur more frequently in children due to the nature of their developing bodies and their active lifestyles. Throughout childhood, normal bone and muscle growth changes in the legs may contribute to heel pain and flat feet. And since children and adolescents can be tough on their feet, ingrown toenails and even warts are common problems.

1. Ingrown Toenail

An ingrown toenail occurs when the edge of the nail, usually on the big toe, grows into the skin adjacent to it. This causes pain and often results in an infection. Ingrown toenails are a problem that can affect anyone regardless of age, but they do occur frequently in children, especially teens. This may be due in part to shoe wear, since a child is more likely to experience tight-fitting shoes as growth spurts occur. What we often see in podiatry is an adolescent patient with an ingrown toenail that may have been present for a few days or even weeks --the result is an infection of the skin surrounding the ingrown nail. The infected skin will often appear very red and swollen.

2. Plantar Warts

A plantar wart is a skin lesion on the sole of the foot that is caused by a virus. A plantar wart is often mistaken for a corn or callous because it has a similar appearance, usually a circular area of thick skin that creates discomfort with weight-bearing. The classic sign of a wart is the appearance of tiny "black dots" within the lesion. Warts can occur on any area of skin, including around toenails, but they tend to occur on the sole of the foot because this area is the most susceptible to micro-trauma which creates an entry point for the wart virus. Warts seem to be more prevalent in children and young adults; one theory is that adults have had more time to develop immunity to the wart virus.

3. Flat Feet

Catherine Moyer, DPM

Pes planus or flat feet, which are feet with minimal to no arches, are a common concern for many parents. A child may have flat feet for a variety of reasons, including orthopedic developmental changes that may be outgrown with no lasting problems. Treatment becomes necessary if flat feet are associated with foot or leg pain, lead to difficulty walking, or if one foot is flat relative to the other. Certain congenital foot defects that cause severe flattening will also require treatment. A common treatment for flat feet is orthotics or arch supports which control pronation. Pronation is the tendency for the arch to collapse and the foot to splay outward.

4. Heel Pain

Catherine Moyer, DPM

Heel pain can be caused by plantar fasciitis which is an inflamed area of the heel bone where a thick band of tissue called the plantar fascia attaches. This type of heel pain occurs on the bottom of the heel either with activity or after rest. Heel pain in the back of the heel is common in adolescents and may be caused by a condition called Sever's disease. Sever's disease is pain along a growth plate at the back of the heel and usually occurs in active children aged 8-14. The pain is caused by strain from the achilles tendon which attaches to the back of the heel. One reason children may be susceptible to heel pain is that calf muscles and the achilles tendon are tight during growth spurts, which puts stress on the heel bone.

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