A comprehensive list of common foot and leg issues in children

A comprehensive list of common foot and leg issues in children

A comprehensive list of common foot and leg issues in children

Category

Flat Foot
Toe in
Hallux Valgus (Bunion)
Leg Length Discrepancy
Growing Pains
Calcaneal Apophysitis (Sever's Disease)

Flat Foot

Characteristics
• The arch of the foot flattens when standing.
Heel valgus is commonly seen

Flat feet can be classified as

Flexible Flat Foot

Definition: Caused by excessive flexibility of the foot’s ligaments and tendons.

Structural Flat Foot

Definition: The joint is rigid, resulting in a long-term collapsed arch.

Symptoms

  • Fatigue or pain in the feet and legs during prolonged standing or walking.
  • Instability when standing on one foot.

Golden Period (Ages 4-13)

If flat feet characteristics or symptoms present during this stage, timely intervention is recommended to reduce the chances of developing the following complications in adulthood:

Complications

  • Plantar fasciitis
  • Heel spurs
  • Hallux valgus (bunions)
  • Lower back pain
  • Heel pain
  • Degenerative joint disease (osteoarthritis)

Do you have flat foot?

Simple Test

Parents can wet their child’s feet and have them step onto a piece of paper to observe the footprints.

Which type of flat feet do you belong to?

Toe in

Definition

Toe in refers to a condition where the foot pointed inward during walking, commonly seen in children under the age of 6. There is a misconception that swapping shoes between the left and right foot can correct knock knees, but this practice does not yield corrective results.

Causes

Metatarsus adductus: The heel is tilted towards the third to fifth toes, which is commonly seen in children under 4 years old.

Tibial torsion: Normal phenomenon before the age of 3.

Femoral anteversion: Normal phenomenon before the age of 6. 

If these conditions persist after the age of 6, interventions are required.

Symptoms and Impacts
  • Fatigue and tripping easily in the feet
  •  Aesthetic concerns

 

Treatment Options

Mild Toe in

Inducing external rotation with wedge insoles placed under the fourth and fifth metatarsal heads, creating torsion during foot propulsion to encourage slight external rotation during walking.

Exercise

Engaging in activities such as swimming (breaststroke) and cycling, which exercise the gluteal muscles and guide external rotation of the femur.

前掌內收 - 反楦 / 直楦鞋

在後跟,中足,及前足施力(三點矯正), 把前掌拉至理想位置

輕微內八字 - 誘導外八鞋墊

在足部第 4 , 5 蹠骨頭延伸,在足部推送 時產生扭力,誘導走路時足部輕微外旋

脛骨及股骨內旋 - 扭力帶

在髖關節產生扭力,誘導走路時回復正常

運動 - 蛙泳運動及踏單車運動

鍛煉臀部肌肉,引導股骨外旋

Hallux Valgus (Bunion)

Definition

Hallux valgus refers to the condition where the big toe deviates towards other toes by 15°. When the bursa of the first metatarsophalangeal joint is compressed, it can result in a swollen bunion. Early control of the condition can reduce the chances of future complications.

Causes
  • Ligament laxity and fallen arches.
  • Genetic factors.
  • Gout/arthritis.
Symptoms and Impacts
  • Deviation and enlargement of the big toe/bunion.
  • Long-term effects: Degeneration, deformity, pain, calluses, and walking difficulties in the first metatarsophalangeal joint.

Treatment Options

1. Foot orthotics:
• Control fallen arches.
• Slow down the progression of bunion deformity (cannot reverse existing deformities).

2. Foot care accessories:
• Bunion splint: Used during rest.
• Toe separators: Used during walking to effectively alleviate hallux valgus (bunion) problems and reduce the chances of complications and worsening.
• Toe stretchers: Relieve tension in the soft tissues on the inner side of the big toe.

Leg Length Discrepancy

Definition

Leg length discrepancy, also known as uneven leg length, refers to a condition where the lengths of the legs are not equal.

Causes

Structural issues in the bones or joints of the thigh, lower leg, or foot can contribute to leg length discrepancy. It can be categorized as:

  • True Leg Length Discrepancy: Difference in the lengths of the leg bones.
  • Functional Leg Length Discrepancy: Legs have equal skeletal lengths, but there is pelvic or shoulder tilt when standing.
Symptoms
  • Gait abnormalities (“limping”)
  • Uneven strides
  • Frequent falls
  • Commonly associated with lower back pain, knee pain, swollen feet, and shoulders of uneven height
Impacts
  • True leg length discrepancy (difference exceeding 1 cm) can result in pelvic tilt, which may lead to long-term complications such as scoliosis, muscle strain, inflammation, and pain in the lower back and legs.

Treatment Options

Since children are still growing, it is crucial to have a diagnosis from an orthopedic doctor to determine whether it is a true or functional leg length discrepancy before considering any interventions.

  • True Leg Length Discrepancy
    Compensating for the height difference using footwear or shoe inserts. Common methods include:
    • Shoe inserts for elevation
    • External shoe lifts
    • Internal and external shoe lifts

前掌內收 - 反楦 / 直楦鞋

  • Functional Leg Length Discrepancy
    Requires diagnosis by an orthopedic doctor to determine the cause and recommend appropriate treatments.

Growing Pains

Definition

Growing pains refer to severe pain in the lower extremities (particularly in the front of the thighs, knees, and calves) experienced by children between the ages of 3 and 12. These pains occur in the afternoon or at night and are considered a normal response to growth, after injury or pathology has been ruled out by a doctor.

Causes
  • Rapid skeletal growth leading to muscle and ligament tension and pain.

  • Muscle and ligament strain due to conditions such as flat feet or knock knees.

Symptoms and Impacts

Severe pain in the lower extremities, making it difficult for children to fall asleep. The pain usually resolves by morning.

Treatment Options

1. Foot orthotics:

  • Control flat feet and knock knees. Reduce excessive tension on the arches and ankles.

2. Massage the painful area:

  • Gently massage the affected area for about 3-5 minutes.

3. Apply heat to the painful area:

  • Use a warm water bottle or a damp, warm towel to apply heat to the painful area for approximately 10 minutes to alleviate muscle tension.

4. Stretching exercises – Calf muscles:

  • Stand with one foot forward and one foot back, bend the front knee while keeping the back leg straight. Slowly lean the body forward until a stretch is felt in the calf. Hold for 10 seconds, then switch legs and repeat the stretch 10 times.

Calcaneal Apophysitis (Sever's Disease)

Definition

Calcaneal apophysitis, commonly known as Sever’s disease, is a condition that often affects boys aged 8-14 and girls aged 8-10. It occurs when the Achilles tendon exerts excessive traction on the growth plate of the heel bone, leading to inflammation and pain.

Causes
  • Engaging in vigorous physical activities that put excessive strain on the Achilles tendon.
  • Rapid skeletal growth.
  • Flat feet.
Symptoms and Impacts
  • Pain in the area of the growth plate at the back of the heel.
  • Pain in the heel that worsens with walking or running.

Treatment Options

  1. Foot orthotics:
  • Prescription 1: Heel cup with increased depth.
  • Purpose: Concentrate heel fat pad and enhance shock absorption.
  • Prescription 2: Heel lift insert.
    Purpose: Reduce traction and pressure on the growth plate.

2. Stretching exercises – Calf muscles:

  • Stand with one foot forward and one foot back, bend the front knee while keeping the back leg straight. Slowly lean the body forward until a stretch is felt in the calf. Hold for 10 seconds, then switch legs and repeat the stretch 10 times.

3. Reduce physical activity and get plenty of rest.

4. Apply ice to alleviate pain.

Flat Foot
Toe in
Hallux Valgus (Bunion)
Leg Length Discrepancy
Growing Pains
Calcaneal Apophysitis (Sever's Disease)

Flat Foot

Characteristics
• The arch of the foot flattens when standing.
Heel valgus is commonly seen

Flat feet can be classified as

Flexible Flat Foot

Definition: Caused by excessive flexibility of the foot’s ligaments and tendons.

Structural Flat Foot

Definition: The joint is rigid, resulting in a long-term collapsed arch.

Symptoms

  • Fatigue or pain in the feet and legs during prolonged standing or walking.
  • Instability when standing on one foot.

Golden Period (Ages 4-13)

If flat feet characteristics or symptoms present during this stage, timely intervention is recommended to reduce the chances of developing the following complications in adulthood:

Complications

  • Plantar fasciitis
  • Heel spurs
  • Hallux valgus (bunions)
  • Lower back pain
  • Heel pain
  • Degenerative joint disease (osteoarthritis)

Do you have flat foot?

Simple Test

Parents can wet their child’s feet and have them step onto a piece of paper to observe the footprints.

Which type of flat feet do you belong to?

Hallux Valgus (Bunion)

Definition

Hallux valgus refers to the condition where the big toe deviates towards other toes by 15°. When the bursa of the first metatarsophalangeal joint is compressed, it can result in a swollen bunion. Early control of the condition can reduce the chances of future complications.

Causes
  • Ligament laxity and fallen arches.
  • Genetic factors.
  • Gout/arthritis.
Symptoms and Impacts
  • Deviation and enlargement of the big toe/bunion.
  • Long-term effects: Degeneration, deformity, pain, calluses, and walking difficulties in the first metatarsophalangeal joint.

Treatment Options

1. Foot orthotics:
• Control fallen arches.
• Slow down the progression of bunion deformity (cannot reverse existing deformities).

2. Foot care accessories:
• Bunion splint: Used during rest.
• Toe separators: Used during walking to effectively alleviate hallux valgus (bunion) problems and reduce the chances of complications and worsening.
• Toe stretchers: Relieve tension in the soft tissues on the inner side of the big toe.

Leg Length Discrepancy

Definition

Leg length discrepancy, also known as uneven leg length, refers to a condition where the lengths of the legs are not equal.

Causes

Structural issues in the bones or joints of the thigh, lower leg, or foot can contribute to leg length discrepancy. It can be categorized as:

  • True Leg Length Discrepancy: Difference in the lengths of the leg bones.
  • Functional Leg Length Discrepancy: Legs have equal skeletal lengths, but there is pelvic or shoulder tilt when standing.
Symptoms
  • Gait abnormalities (“limping”)
  • Uneven strides
  • Frequent falls
  • Commonly associated with lower back pain, knee pain, swollen feet, and shoulders of uneven height
Impacts
  • True leg length discrepancy (difference exceeding 1 cm) can result in pelvic tilt, which may lead to long-term complications such as scoliosis, muscle strain, inflammation, and pain in the lower back and legs.

Treatment Options

Since children are still growing, it is crucial to have a diagnosis from an orthopedic doctor to determine whether it is a true or functional leg length discrepancy before considering any interventions.

  • True Leg Length Discrepancy
    Compensating for the height difference using footwear or shoe inserts. Common methods include:
    • Shoe inserts for elevation
    • External shoe lifts
    • Internal and external shoe lifts

前掌內收 - 反楦 / 直楦鞋

  • Functional Leg Length Discrepancy
    Requires diagnosis by an orthopedic doctor to determine the cause and recommend appropriate treatments.

Growing Pains

Definition

Growing pains refer to severe pain in the lower extremities (particularly in the front of the thighs, knees, and calves) experienced by children between the ages of 3 and 12. These pains occur in the afternoon or at night and are considered a normal response to growth, after injury or pathology has been ruled out by a doctor.

Causes
  • Rapid skeletal growth leading to muscle and ligament tension and pain.

  • Muscle and ligament strain due to conditions such as flat feet or knock knees.

Symptoms and Impacts

Severe pain in the lower extremities, making it difficult for children to fall asleep. The pain usually resolves by morning.

Treatment Options

1. Foot orthotics:

  • Control flat feet and knock knees. Reduce excessive tension on the arches and ankles.

2. Massage the painful area:

  • Gently massage the affected area for about 3-5 minutes.

3. Apply heat to the painful area:

  • Use a warm water bottle or a damp, warm towel to apply heat to the painful area for approximately 10 minutes to alleviate muscle tension.

4. Stretching exercises – Calf muscles:

  • Stand with one foot forward and one foot back, bend the front knee while keeping the back leg straight. Slowly lean the body forward until a stretch is felt in the calf. Hold for 10 seconds, then switch legs and repeat the stretch 10 times.

Calcaneal Apophysitis (Sever's Disease)

Definition

Calcaneal apophysitis, commonly known as Sever’s disease, is a condition that often affects boys aged 8-14 and girls aged 8-10. It occurs when the Achilles tendon exerts excessive traction on the growth plate of the heel bone, leading to inflammation and pain.

Causes
  • Engaging in vigorous physical activities that put excessive strain on the Achilles tendon.
  • Rapid skeletal growth.
  • Flat feet.
Symptoms and Impacts
  • Pain in the area of the growth plate at the back of the heel.
  • Pain in the heel that worsens with walking or running.

Treatment Options

  1. Foot orthotics:
  • Prescription 1: Heel cup with increased depth.
  • Purpose: Concentrate heel fat pad and enhance shock absorption.
  • Prescription 2: Heel lift insert.
    Purpose: Reduce traction and pressure on the growth plate.

2. Stretching exercises – Calf muscles:

  • Stand with one foot forward and one foot back, bend the front knee while keeping the back leg straight. Slowly lean the body forward until a stretch is felt in the calf. Hold for 10 seconds, then switch legs and repeat the stretch 10 times.

3. Reduce physical activity and get plenty of rest.

4. Apply ice to alleviate pain.

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