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With the kickoff of another school year, kids hurry back to school in their shiny new clothes and shoes. Excited to be social again after a long summer with the family, kids are quickly hit with the reality of homework and listening and studying and exams. The bounce in their step sometimes turns into dragging feet. Sometimes there are other reasons behind those dragging feet.
Overuse Injuries in kids
Kids are somewhat prone to overuse injuries due to the active growth plates in the many bones of the feet, ankles, and legs. With 26 bones per foot, there are many possibilities for trouble. The most common problem spots are the heel bone, sesamoids (under the big toe joint), lower legs/shins, and navicular (inside arch).
Heel pain in children: The growth plate in the heel is susceptible due to the tight Achilles tendon attachment on the back-side and the plantar fascia on the bottom. In addition to the impact of heel strike, there’s almost a tug-of-war that can happen with running, sprinting, jumping, tumbling, and marching type activities. Kids with flat feet and a tight Achilles tendon are more prone to developing this “Sever’s disease”, an inflammation of the growth plate in the heel. Anyone playing multiple sports concurrently, or working out 5-7 days per week are also at risk. Kids between 9-12 are hit most often with Sever’s.
Sesamoid fractures: There are 2 small bones under the big toe joint. Kids with a high arch foot are more susceptible to this injury. An acute jarring injury or hyperextension injury can also cause fracture to this sesamoid bone.
Shin Splints: Pain in the lower legs can be growing pains if it’s felt to be in the bone. But more often than not, it’s shin splints. This is pain along the tendons/muscle as they attach to the leg bones. It’s more common with tight muscle groups and feet that pronate (flatten) or supinate (high arch) more than normal.
Navicular Injuries: Residing at the inside arch, just down from the ankle is the navicular. This bone can often come with an extra round bone fragment on the inside of the arch that can be a problem for many kids, especially those with a tendency to a flatter arch.
How to treat overuse injuries in kids
Listen to kids who complain, and jump on the issue. Prompt care leads to a quicker and more successful treatment. So get them checked out early: pediatrician, urgent care, or go straight to the foot and ankle specialists.
Rest. This is tough for multi-sport athletes, but if caught earlier, a brief rest can get them out of trouble.
Anti-inflammatory medications can help reduce inflammation and relieve pain. Icing the injury and homeopathic medications, such as Traumeel, can also be of help.
Stretching and physical therapy can be prescribed to decrease pain and increase flexibility.
Orthotics can help correct poor foot position and alignment. A boot or cast can keep the foot in a supported position while it heals.
Kids and Ingrown Toenails
Some kids just get them, no matter how the nails are cut. In general, cutting toenails straight across or gently curving them to match the shape of the toe is appropriate. It’s important to avoid tight shoes that can compress against the toes. Kids who are growing rapidly may have well fitting shoes in September but are too tight come Thanksgiving.
If you see one developing, it’s best to soak in warm water and Epsom salts. Apply some antiseptic, alcohol or Hydrogen Peroxide, and a topical antibiotic. If it persists, an antibiotic can often help when it becomes red with pus. We are well equipped to do an efficient ingrown toenail procedure in the office when appropriate. A cold spray can help numb the skin prior to a numbing shot to facilitate a quick procedure to fix an ingrown toenail. A permanent procedure is often offered as the best long-term lifetime fix.
Plantar Warts
Plantar warts are a common problem for kids, a virus that sets up in the bottom of thefoot. Some kids seem more susceptible. They are commonly picked up in warm, moist areas such as community swimming pools, hot tubs, etc. Once you get them, they are contagious and can spread to other parts or to other people. It’s important not to pick at them. Initial treatments can be over the counter things such as Compound W, Wart-off, and such. If this fails, we offer a few different treatments that can usually quickly eliminate these tough viruses. Freezing, application of blistering agents, topical creams, injection of blistering agents, and surgical excision are all options considered, arriving at the best approach after discussing with the child and parents.
This has been a quick rundown of some of the common issues that zaps the bounce in our kids step and causes them to drag their feet around. We love to help kids, and welcome you at the Dr. Bob Baravarian where we are well equipped to evaluate and offer treatments to promote a quick and full recovery. Go Kids!
If you would like more information about pediatric foot and ankle conditions, please call us at (855) 557-5400 or visit us at www.footankleinstitute.com.
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