Taking care of common kids’ foot complaints

Taking care of common kids’ foot complaints

Taking care of common kids’ foot complaints - 1

Taking care of common kids’ foot complaints

While most parents worry about the health of their child’s eyes and teeth, many overlook the state of their kids’ feet. Feet are amazing; not only do they enable us to stand tall and move, they support our body weight and act as shock absorbers, in turn protecting our ankles, knees, hips and spine.

In young children the foot is pliable to allow it to develop, which means taking care of feet during the first few years of a child’s life is vital.

Recognising common foot complaints can help ensure that action is taken to address the problem and ensure your child’s feet continue to develop in a healthy way.

Taking care of common kids’ foot complaints - 2

Ingrown toenails

Ingrown toenails are common with multiple causes. Widespread causes can include clipping the nails too short, cutting or picking at the edges of the nail, trauma to the nail due to kicking sports, excessively sweaty feet and pressure from footwear. All of these events can create a sharp edge on the nail, which can pierce the skin and lead to an ingrown toenail.

The symptoms of an ingrown toenail (onychocrytosis) can include a sore toe, pain at one side of the toenail and, in severe cases, a pus-filled discharge. In most cases it’s usually the big toe that’s affected.

Closed-toe shoes are likely to increase the intensity of the pain and, if left untreated, it’s common for the toenail to become infected making it difficult to walk and particularly painful to play sport.

To treat an ingrown toenail start by soaking the foot daily in warm, salty water, gently patting dry and applying a topical antiseptic. If possible, refrain from wearing enclosed shoes.

If the issue does not resolve within a couple of days it may require treatment by a podiatrist. This is a simple procedure that involves removing the small, sharp portion of nail causing the grief and dressing the nail to protect against infection. It usually takes minutes.

In acute cases nail surgery may be required.

Taking care of common kids’ foot complaints - 3

Flat feet

In infants flat feet is common because they have a fat pad under the foot that hides the developing arch. By about the age of eight, the foot arch becomes apparent. Yet some children never develop an arch and this is called ‘flat feet’.

Flat feet or pronated feet (foot and ankle roll inwards) can be hereditary or due to muscle length and tone. In some instances the condition causes no pain or discomfort but in other cases flat feet or over pronated feet can cause pain in multiple areas of the body including the foot itself, shins, knees, lower back and Achilles tendons.

A podiatrist can help treat flat feet using orthotics, which hold the feet in their correct position and help relieve the associated pain. A detailed biomechanical analysis is conducted to diagnose which type of orthotics is best (there are many!).

In addition to orthotics, a podiatrist can advise on other measures that can be taken as part of a multi-pronged treatment plan. This may include stretching, strengthening exercises or deep connective tissue massage. Bare in mind that being overweight or wearing poor footwear can contribute to the symptoms of flat feet.

Plantar warts

Warts can be the bane of a parent’s life because they are so easy to contract, yet notoriously difficult to get rid of.

Often mistaken for corns, plantar warts appear as small (less than 5mm) rough, flat bumps on the bottom of the foot—usually on the underside of the toes, heel or forefoot. Some plantar warts have little black dots in the centre. This is caused by small blood vessels.

Warts are the result of a virus, so they are easily transferred to other children and adults and are particularly common in swimming pools, gyms, communal showers and other places that involve water, warmth and bare feet.

There’s a plethora of treatments for plantar warts but many are lengthy and not always successful. If over-the-counter non-prescription medicines don’t work, you can try a prescription medication such as salicylic acid or cryotherapy, which involves freezing the wart with liquid nitrogen.

Alternatively, your local podiatrist can use laser treatment or a small instrument to remove the wart. To prevent future plantar warts, avoid letting your child go barefoot in high-risk places such as public showers and outdoor swimming pools.

Want to know more about taking care of kids’ feet? Visit: mykidsfootdoctor.com.au.

Got a question? Ask Dr Foot

A Step Ahead Foot + Ankle Care is one of Sydney’s leading foot and ankle clinics. Principal podiatrist and founder of A Step Ahead Dr Brenden Brown (AKA Dr Foot) has been taking care of people’s feet for more than 20 years. With a background in sports medicine and having served as a former president of the Australasian Podiatry Council, Brenden is a wealth of information when it comes to foot and ankle care.

Related blogs:

Does your child need to see a podiatrist?

Are growing pains causing your child discomfort?

Growing Pains-  More than just pain from growing – A case study

Growing Pains- More than just pain from growing – A case study

Growing Pains-  More than just pain from growing - A case study - 1

Growing Pains- More than just pain from growing – A case study

Sam is 10-years-old. He’s a great kid who loves being active, but there’s a problem and it’s getting worse. Sam plays football in winter and, in summer, he’s a cricket fanatic. Apart from these regular sports he’s running about at school and is, yes your average Aussie kid!

Sam’s mum and dad brought him into A Step Ahead Foot + Ankle Care because, despite being a very happy and active kid, Sam is waking up a couple of nights a week with pain in his lower legs. When he wakes he wants his mum to rub his legs because they ache and are sore. Sam’s mum Beth has used heat packs and paracetamol which does take the pain away after a while but, as Beth says, “They aren’t fixing the cause”.

A key factor is that fact Sam’s parents recognised that the pain sometimes came on in the night after Sam had quite active days, like sports days or family activities with lots of walking.

Visiting the GP, Physio and Dr Google

Sam’s parents took their son to a GP who sent them to see a Physiotherapist. While the physio was nice and showed Sam some stretching and did a couple of massages, these again helped at the time but didn’t stop the problem from coming back. After chatting to the GP their opinion was that this was “Just growing pains”—something Sam would have to get used to, and that he would simply “Grow out of it”. Frustrated with a fantastic but upset little boy, Sam’s parents felt they needed another opinion.

Sam’s mum Beth jumped onto Dr Google and found herself even more confused. Some parents were recommending vitamin supplements, others recommended oils and others suggested all kinds of home remedies. She then found herself on Facebook asking other parents for help. This is where a friend of Beth’s recommended our practitioners at A Step Ahead Foot and Ankle Care.

Growing Pains-  More than just pain from growing - A case study - 2

Finally some answers

When our practitioners assessed Sam it became pretty clear there was more than just some kind of phantom pain going on. We undertook a detailed walk and run assessment, along with some measurements and testing on Sam’s muscles. Nothing was invasive and everything we do is done in a fun, friendly and non-confronting environment. After a short while we established that Sam’s feet were rolling in a lot and his arches where a little flat. In essence Sam had pretty poor foot posture. What this meant is that the muscles in Sam’s lower legs were over working to try and give his poor foot posture support.

This meant that a big day on his feet, like a family outing, a busy day at school or doing sports caused his muscles to work even harder. This led to them getting sore, not necessarily at the time of the injury, mostly at night several hours after the muscles had rested.

Helping fight “growing pains”

To help Sam we gave him a custom-made pair of orthotic insoles. These are made from a soft material so are very comfortable to wear but provided support for the rolling of his ankle. We took a 3D scan of Sam’s foot and video recorded his walking patterns using our specialised assessment software. The orthotics are then designed using our computer-aided design software. Next step is to make the orthotics, which is done in our on-site Orthotic laboratory by our technicians and overseen by our podiatrist.

After fitting his new orthotics into a new pair of runners that we recommended, Sam headed on his way feeling comfortable to return in a couple of weeks. We prescribed some stretching to work with his orthoses and suggested that we may need to follow this up with a specialised massage to relax his muscles as his orthoses took over and began doing their job.

Pain free!

A couple of weeks later a very relieved set of parents and Sam returned to our clinic. In a little over two weeks the orthoses had started to do their thing. Sam had only had pain in his legs once since starting to wear his orthoses and this was after a very big day, his school athletics carnival! After only a couple of weeks we expected this to decrease so we asked them to return in another month at which time they reported Sam to be pain free!! Sam’s parents also reported that he was much more comfortable at sport as well. They were overjoyed; they had their happy, healthy little boy back!

Growing pains ARE TREATABLE in most cases. While many well-meaning health practitioners may say you have to wait and outgrow growing pains, there are alternatives. Our practitioners have had the pleasure of helping many kids with this same problem. It’s what we love to do! Helping kids become pain free, happy, healthy and active is a privilege. If you would like to help your little one to become pain free, please give our helpful reception team a call on +61 9673 2987 or 4732 2007. You can also see find us on our Facebook page https://www.facebook.com/podiatristsydney

Tripping, falling, clumsy or Growing pains – Is it really normal?

Tripping, falling, clumsy or Growing pains – Is it really normal?

Tripping, falling, clumsy or Growing pains - Is it really normal? - 1

Tripping, falling, clumsy or Growing pains – Is it really normal?

Is growing really responsible for your little one’s discomfort?

So, your little one is having a tough time and, therefore, so are you! There’s something not quite right but you just can’t put your finger on it.

Perhaps they seem clumsy, or they trip and fall a little more than their friends of the same age.  Maybe they don’t want to walk distances. Perhaps it appears they tire out more than the other kids. Sound familiar?

One of the most frustrating things for a parent or carer is having a child that, for no know apparent reason, wakes at night with pain in their feet legs and lower limbs. Often they’ll be in tears with pain. You’ve tried massaging them, or heat packs. You may have tried Panadol and Nurofen.

What you need is answers!

You head to the GP to tell them the things you’ve noticed. Frustratingly you’re told, “they will grow out of it” or…

“it’s growing pains” or…

“All kids get that” or …

“There’s nothing that you can do” or…

“Oh, it’s completely normal”

Whaaaaaat – You scream!!!

Well we don’t think it’s normal and there is something you can do!

All of the above are classic symptoms we see and recognise as signs your child has foot and lower limb posture problems, and this most certainly CAN be treated.

Tripping, falling, clumsy or Growing pains - Is it really normal? - 2

Getting rid of your child’s pain

We see hundreds of kids who present with their parents with very similar complaints each and every year. Frustrated parents with children who are looking for answers.

One of the most rewarding things about being a practitioner is getting these kids back to health, activity and pain free! To do this we start by running through a detailed history. We examine walking, standing and posture.

We will then recommend treatment aimed at stopping the pain and making your child comfortable (and happy!) again. We provide useful suggestions around footwear, prescribe therapies like massage or orthotics alongside possibly stretching and muscle strength exercises – all aimed at kids and designed to be kid friendly!

Results that make you smile!

There is nothing better than seeing a once uncomfortable child who woke at night crying sitting in your office with a big smile! With parents who have equally enormous smiles!

Parents get to see their once-clumsy-child running around without as many grazed knees. Many mums feel relieved that they no longer have to continuously pick up their child or push them endlessly in the pram because they can now walk distances complaint free!

As a clinic we see numerous kids each week, and we LOVE it! There is little greater than knowing you’ve made someone else’s life just a little bit better. It’s quite addictive.

In an age where we find ourselves complaining that our kids need to “get outside and play more” or we’re constantly saying “put your device down” it’s important that we make certain that they have the ability to be active – without pain.

Too many times we have meet frustrated parents and upset kids who come into our office after being told there is nothing they can do only to find they could have been making things better weeks months or even years earlier!

Tripping, falling, clumsy or Growing pains - Is it really normal? - 3

First steps

Is this sounds all too familiar, we’d like to help. Perhaps this is something that a friend or relative may benefit from. If that’s the case we’d love you to share it with them so they can find relief!

A Step Ahead Foot + Ankle Care is based in Western Sydney. We have multiple practitioners with loads of experience treating kids! Its our passion!

If you’d like more information please contact our helpful front desk team. They are brilliant at working through what help you need, guiding you to the appointment that is right for your family, running through costings and then reserving your appointment time. Call us today on +61 2 9673 2987 we look forward to helping.

Have you checked out our page dedicated to kids’ foot problems? Click here for more information.

Got a question? Visit us on instagram #AskDrFoot

In toeing , kids tripping, being a little uncoordinated and making kids smile!

In toeing , kids tripping, being a little uncoordinated and making kids smile!

“I didn’t think it was a big problem, I mean she trips over but I thought she was just a bit uncoordinated. Her Dad wanted me to get her checked out so here I am!”

In toeing , kids tripping, being a little uncoordinated and making kids smile! - 1

In toeing , kids tripping, being a little uncoordinated and making kids smile!

Wow, this is an all too common sentence we hear from mums and dads!
After a thorough bio-mechanical examination “walk, run, posture assessment”, and some experimentation with the clinic whoopee cushions, we popped young Jessy on our state of the art dart fish gait (Run / walk) analysis system and there it was.

“Wow I didn’t realise her foot turned in THAT much!” said mum.

As In-toeing and Metatarsus Adductus is something we see and treat daily (I saw it 3 times just yesterday!), we had to hide the smiles on our faces. We knew we could get Jess to comfortably run and play sport again without tripping! about 40 mins later, armed with some detailed footwear advice, and a copy of her 3D laser scan for her Orthotics/Insoles in her hands, mum and Jess left the clinic with some answers.

See you in 2 weeks for your Orthotic Fit Jess!

Brenden Brown (BB)

A Step Ahead Foot and Ankle Care,

Founders of My Kids Foot Doctor!

Standing on your feet for long periods at work

Standing on your feet for long periods at work

Standing occupations and what happens to feet!

Standing on your feet for long periods at work

Busy looking people!

Most of us stand or walk everyday but amongst us there is a proportion of our population that do it more than others. We are talking to you Nurses, Builders, Hairdressers, Concreter’s, Teachers, process line factory workers and Check out operators and, and, and and! You guys know more than anyone what a toll standing for hours can do to your feet. Below is a very quick description of some of the more common problems you may have suffered and things we as foot specialists see day in day out and help to treat.

Plantar plate tears / injuries / dysfunction

Is this you? (What it can look like)

• Do you have pain in the ball of your foot? Is it worsened when you stand or possibly wear shoes?

Standing on your feet for long periods at work - 2

• Have you developed the feeling of a lump or a little pea under the ball of your foot?
• Is there dry hard skin (callus) developing under the ball of your foot?
• Have you noticed a small (or large) gap developing between your toes that resembles “V”? This is often the 2nd and 3rd toes, but it maybe any?
• How did it happen? Do you remember tripping falling and developing a pain in your forefoot (ball)? NO you DO NOT have to have had an accident!
• It may have developed slowly over time with no memory of a painful incident.

We see this many times a week and sadly we often see it misdiagnosed and therefore treated as the wrong problem. It can be misdiagnosed as a Mortons Neuroma or at times when people aren’t sure of things (and for many years) some practitioners diagnose Metatarsalgia .
Remember “Grandma’s feet? You know the ones where her big toe had formed a bunion and the next two toes popped up and crossed over each other? Yes those feet you wished you would never get, and swore you would never let it happen to you! Guess what without having it treated pronto –they soon may be yours!

Correct Diagnosis

A big part of this problem is misdiagnosis! You cant diagnose this if you don’t see a stack of it. As a clinic we will always send you for a Ultrasound BUT not just to anyone! Some radiologists commonly miss this and sadly are not familiar with the condition. Make sure when you are referred to get a diagnosis the radiologist knows and has diagnosed Plantar plate tears before!
Clinically your podiatrist should be able to see this quickly but it can be tricky and some Pods are more equipped for general nail care. Choose someone who sees this regularly! ASK!

Treatment

Strong supportive footwear is a key here! Shoes should be solid on the base not bend or twist. Cushioning this condition with fancy air bubbles WILL NOT fix this!

Orthotics (Custom made) – Well-made and designed orthotics will assist poor foot posture and correct alignment. They cannot come out of a packet and fix this, they need to be designed to help address this.

Soft tissue therapy – This condition is often slated straight to surgery STOOOOOOOOP! Unequivocally this condition has a good prognosis with conservative therapy trail first! We see this condition many times a day and get great success. Now we realise not all Pods do soft tissue like we do (Come on pods get to it!) but this is really necessary to go hand in hand with your Orthoses. Orthoses alone WILL NOT fix this. If your Pod wont do soft tissue then find a physio who will!

Surgery. Yes if this condition progresses to an unresolvable tear there is a need for us to refer you to an orthopaedic surgeon for surgery. SURGERY is A LAST resort! On most occasions surgery can be avoided with early quality intervention. As a note we worry about the amount of these we see that have unnecessarily sent to a surgeon. Many times way too early and before conservative care I has been trailed correctly these patients (you) are sent to surgery!

Heel pain

Is this you? (What it can look like)

• Pain on the first few step in the morning or pain on rising after sitting (Or Both)
• Pain Located in the heel area, under the heel where the slightly fatty area is, or pain in the Achilles running up the back of the lower leg.
• Pain may initially subside in first stages after first few steps
• Pain worsened by long period on your feet may become painful after walking or activity for reasonable periods of time.

Standing on your feet for long periods at work - 3

Correct Diagnosis

The first thing your friends will tell you is “It’s a Heel spur”. Sadly life is not that simple and where once medicos lumped this into one general diagnosis (Sadly some still do). We recognise that this set of symptoms may be one of many conditions. Plantar fasciitis, fatty pad syndrome, Achilles tendonitis, and even Abductor Hallucis tendonitis can contribute to this pain. Find a practitioner who knows the difference! Again not all practitioners see these things a lot.
At times simple clinical signs are enough, but diagnosis maybe needed via radiology such as diagnostic ultrasound. Xray will show you a spur (Yes I know) but the bony spur is NOT the problem.

Treatment

Strong supportive footwear is a key here yet again ! Shoes should be solid on the base not bend or twist. Cushioning this condition with fancy air bubbles WILL NOT fix this!

Orthotics (Custom made) – Well-made and designed orthotics will assist poor foot posture and correct alignment. They cannot come out of a packet and fix this; they need to be designed to help address this.

Soft tissue therapy – Deep connective tissue massage, will be useful in all the above conditions. Again be wary of people simply telling you that orthotics will get rid of this. They go hand in hand but are not the only answer.

Shockwave – As a clinic we have been using shockwave for about 3 and a half years. As we are “early adopters” of new therapies, this is not as common to other practitioners but the use of this therapy is very handy and growing in popularity. We find this takes half the time that Deep connective tissue does to relieve this in combination with the other therapies.

Stretching – there are some very specific stretches that can be used for this group on conditions and for a large group of individuals this will help. Don’t be discouraged if these don’t work. Look above there are more options and solutions.

Tibialis Posterior dysfunction.
(Super flat feet / Fallen arches)

Is this you? (What it can look like)

• Pain in and around the arch. May be worse after walking or standing
• Discovering you have a “Fallen arch”
• Noticing one arch is lower than the other.
• Pain fatigue during or after walking. Pain on standing on toes ,climbing ladders.Standing on your feet for long periods at work - 4

Correct Diagnosis

This should be fairly easy to diagnose. The lowering of one arch, as opposed to the other, in combination with pain located in the arch. Should lead to an easy diagnosis. Diagnostic Ultrasound maybe used and your Podiatrist (us) can refer you off for this.

Treatment

Strong supportive footwear is a key here yet again and now again ! Shoes should be solid on the base not bend or twist. Cushioning this condition with fancy air bubbles WILL NOT fix this! (Can you see a pattern)

Orthotics (Custom made) – Well-made and designed orthotics will assist poor foot posture and correct alignment. They cannot come out of a packet and fix this; they need to be designed to help address this. IN particular without orthoses this condition WILL NOT get better! Get them and GET THEM QUICKLY!

Soft tissue therapy – Deep connective tissue massage, will be useful in all the above conditions. Again be wary of people simply telling you that orthotics will get rid of this. They go hand in hand but are not the only answer.

Braces – In the initial stages having braces specifically designed to support the arch will support and make steady the arch. It works well at first but is really a short term solution. Look towards orthoses and soft tissue.

Surgery. Yes if this condition progresses to a tear there is a need for us to refer you to an orthopaedic surgeon for surgery. On most occasions surgery can be avoided with early quality intervention.

Bunions

Is this you? (What it can look like)

• Your big toe starts to point out towards the smaller toes and is no longer straight

Standing on your feet for long periods at work - 5

• Pain may develop around the big toe joint. Making it difficult to walk or stand
• Many people can have a bunion and not have any pain.
• The toe may begin to twist as well

Correct Diagnosis

On most occasion a qualified health practitioner should be able to diagnose this simply by looking at the clinical signs, however you may require a xray if you are considering surgical intervention.

Treatment

Strong supportive footwear. (Wow we just wont stop talking about this supportive footwear will we!!!) Shoes should be solid on the base not bend or twist. Cushioning this condition with fancy air bubbles WILL NOT fix this! (Can you see a pattern)

Orthotics (Custom made) – Well-made and designed orthotics will assist poor foot posture and correct alignment. This problem is often a result of a variance in the structure of your feet Yet again these cannot come out of a packet and fix this; they need to be designed to help address this.

Soft tissue therapy – Deep connective tissue massage, will be useful in all the above conditions. There is a problem with the balance of two muscle in your feet. This can also lead to another condition that may damage other muscles and soft tissue structure, the plantar plate rupture or dysfunction. Again be wary of people simply telling you that orthotics will get rid of this. They go hand in hand but are not the only answer.

Braces – Often called night splints there is some research that suggests these can be really helpful. I (Brenden) am a little dubious! This relies on you being super diligent on putting the splint on night after night. I always argue that on a Friday night after a busy week and a catch up with the girls after work it’s not likely you’ll want to pop this on before heading to bed. This is where the success of these will fall down BUT if you are super diligent, give them a try.Standing on your feet for long periods at work - 6

Surgery. Yes if this condition progresses there is often a need or want for us to refer you to an orthopaedic surgeon for surgery. This surgery over years has increased in its success. See a orthopod who does this all the time. Why ? Because ensuring that the person does this and other foot surgeries often increases the chance of success. If they are also doing shoulders knees hips wrists etc etc they simply cant be as use to doing this surgery as someone who does this every day.

The HARD sell !
At A Step Ahead foot + Ankle care we see several patients a day with this condition. We have patients that travel literally hundreds of kilometers to seek our help –which is really lovely! Our clinics are set up quite specifically to treat patients with muscle injuries and mechanical problems with their feet. We have invested hundreds of thousands of dollars into equipment and the latest technology to help us, help you- beat your pain.
Our principal Podiatrist Brenden Brown is recognized as one of Australia’s leading experts in Podiatry (No really). A past President of the Australasian Podiatry council he is regularly asked for his opinion in the media, appearing regularly on television shows like the Today Show and Magazines like Men’s Health.
It would be a pleasure to help you beat your foot pain.
We are located in Penrith and St Marys in Sydney’s Western suburbs. You can contact us on 47322007 or 96732987 we hope you will……. See that wasn’t so bad was it!

Copyright 2015.   We take our copyright quite seriously. If you reproduce this without seeking our permission we will be very upset. So upset we will contact our solicitor and instruct them to deal with you. Big hairy scary with a steely glare enormous shoulders and a square jaw she will take you to task! We will instruct her to take all necessary measures to recompense us for your infringement on our intellectual property and copyright!
If you would like to reproduce this and are happy to acknowledge our company and share a link to our website then we will most likely be happy to allow you to reproduce this, but hey why not ask!