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Q&A: Foot problems

Q: We know a family whose children always seem to have foot problems. Is this something most families will deal with at some point?

Check out a few of the foot facts from the American Podiatric Medical Association and you’ll soon surmise that feet deserve a whole lot more attention that we typically give them:

  • Each human foot has 26 bones, 33 joints, 107 ligaments and 19 muscles.
  • There are more than 300 different foot ailments.
  • 75 percent of Americans will experience some type of foot-related health problem over their lifetimes.

Many foot experts agree that a child’s first year of life is the most important period for foot development. Beware of shoes, sleepwear or blankets that restrict foot movement. Never force a child to walk before he or she is ready. Once walking, kids need to wear shoes outside but benefit from walking barefoot or in socks when indoors.

Careful observation when a child walks can reveal potential problems. Toes that turn in or out, or knees that knock, warrant a trip to the pediatrician or podiatrist.

Growing children may change shoe sizes every few months, so frequent fittings are a good idea. Hand-me-down shoes are a no-no.

Teach your children about good foot health care when they’re young, urges pediatric podiatrist Peter Mitchell, M.D. of Phoenix. Discourage picking at or tearing toenails. A clean, straight cut at trim time will help prevent painful ingrown toenails.

Encourage kids to take off their socks and shoes now and then so moisture created by the 125,000 or so sweat glands in each foot won’t stay trapped against the skin. But don’t let kids roam barefoot in dirty settings. Cuts and cracks in the feet are vulnerable to viruses that cause painful skin conditions like plantar warts.

Sports-related overuse injuries can affect the feet. Mitchell says too much activity can trigger pain and inflammation at the growth plate, where the Achilles tendon inserts into the heel. A child who develops foot pain should rest the foot and apply ice to reduce inflammation. If the pain doesn’t resolve in a few days, it’s best to consult a doctor rather than using anti-inflammatory medication on a regular basis.

Pain also can be an indicator of a fracture to one or more bones in the feet. Fractures typically result from some type of blow to the foot, sustained while kicking a hard object or tumbling off a bicycle, for example. Other signs of possible fracture include swelling, bruising, limping and difficulty putting weight on the foot while standing. If your doctor suspects a fracture, your child will need an X-ray.

Problems like flat feet or toes that turn in or out are usually resolved on their own by the age of 5 or 6. Mitchell says it’s often best to do nothing until a child is 10 to 12 years old. Surgery is rarely considered when foot problems aren’t symptomatic.

A child who finds standing painful, can’t keep up with his or her peers or struggles with soccer or similar activities because of foot pain may be a candidate for surgery, says Scottsdale podiatrist Michael Dershowitz, M.D. A relatively non-invasive surgical procedure, involving insertion of an internal orthotic device, often can resolve the problem.

A relatively common foot problem in teens is “tarsal coalition,” a condition in which the bones of the foot don’t separate normally. The condition occurs in one in every 1,000 or so youth and is signaled by flat feet that are rigid rather than flexible, Mitchell says.

“I don’t put these kids in orthotics unless they’re in pain or very active in sports,” says Mitchell. “Orthotics won’t change their arch.”

Many foot problems are genetic, according to Dershowitz. The foot health of parents and grandparents can reveal a lot about potential problems a child may face. Find out whether anyone in your family suffers from flat feet, bunions, hammertoes or other foot problems.

This may help you catch potential problems early, when appropriate treatments, like orthotic shoes, can be used to minimize them.

Now that you have a healthier respect for your family’s feet, here are a few more tips from the American Podiatric Medical Association:

  • Do plenty of walking. It’s a great form of exercise for your feet.
  • Treat foot or ankle injuries with ice rather than heat. Ice numbs the pain and reduces swelling; heat facilitates blood flow and increases swelling.
  • Avoid wearing heels higher than two inches for long periods of time because chronic pain can result.
  • Don’t wear sports shoes that are past their prime or play one sport in shoes designed for a different sport.


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