It is that time of year again. Returning to school and those extra curricular activities. Kids are excited about sports and band practice, but this sudden increase in activity can cause them to have heel pain. Pediatric heel pain is nothing to ignore. It is not your typical adult heel pain caused by plantar fasciitis and will not go away with advil alone. It can be excruciating for some children to the point they cannot walk. So what is it really and why does it happen?
Calcaneal apophysitis is the medical term for inflammation of the growth plate in the heel caused by the pull of the plantar fascia below it and the Achilles tendon above it. As we grow, the bones in the legs get longer, but the muscles and tendons have to stretch to grow with them. If these structures are tight and have not reached the same length as the bones, then they pull much harder on the growth plates. This causes significant pain that usually occurs after activity and improves with rest. Other symptoms including swelling of the heels, pain with pressure and increased warmth.
Treating pediatric heel pain early is important. In our office, youf child will be fully evaluated including xrays to make sure that the growth plate is normal and the pain is not caused from other reasons like a stress fracture. Rest, ice and stretching are key factors in treating heel pain in children. Appropriate shoe gear, orthotics and physical therapy will also improve their pain and reduce recurrence. In severe cases, complete immobilization may be necessary.
If your child is complaining of heel pain, don’t ignore it. This pain can prevent them from participating in the activities they enjoy. At Foot and Ankle Associates of North Texas, we are here to get your children back in the game.
Tuesday, September 1, 2009
Wednesday, March 25, 2009
Are You Kid's Shoes Making Their Feet Deformed?
Children's Shoes Are Too Small and Causing Deformities, a New Study Finds
A new study of 250 children in Switzerland presented by the American Academy of Orthopaedic Surgeons (AAOS) found that a vast majority of young children are wearing shoes that are too small, increasing the risk of foot deformities. "The most striking finding was that more than 90 percent of children's shoes were too small," says Norman Espinosa, MD an orthopaedic surgeon at the University of Zurich. Overly-tight shoes are the leading cause of Hallux Valgus, a condition that occurs when the big toe begins to angle sideways in the direction of the second toe, causing a bump or bunion on the side of the foot.
For more information on juvenile Hallux valgus click here.
A new study of 250 children in Switzerland presented by the American Academy of Orthopaedic Surgeons (AAOS) found that a vast majority of young children are wearing shoes that are too small, increasing the risk of foot deformities. "The most striking finding was that more than 90 percent of children's shoes were too small," says Norman Espinosa, MD an orthopaedic surgeon at the University of Zurich. Overly-tight shoes are the leading cause of Hallux Valgus, a condition that occurs when the big toe begins to angle sideways in the direction of the second toe, causing a bump or bunion on the side of the foot.
For more information on juvenile Hallux valgus click here.
Tuesday, March 24, 2009
Does My Child Have a Bunion?
When we think of bunions, we think of our grandmothers with the worst feet we’ve ever seen. This may be passed down to the next generation, but few realize that bunions can occur in children. This is called juvenile hallux valgus and is more frequent than you think.
Bunions are most commonly inherited. The foot type that causes the deformity is passed down through the generations and can be seen as early as the age of 6. This is when the bones of the arch have fully formed and children are continuing to do more things like run, jump and play.
The deformity is a bump seen at the big toe joint that can be painful with tight shoes or no shoes at all. It can also be painful with increased activity and often barefoot walking causes arch pain or ball of foot pain because of the improper mechanics causing the bunion to form.
So how do you know if your child has a bunion? If you see a bump, most likely that’s what it is. But your best option is to have them evaluated by a foot and ankle specialist who is trained to diagnosis this condition. Xrays should be performed to see if the bones are growing properly. A biomechanical exam will show why the bunion is forming.
Most of the time treatment begins with conservative care and orthotics at this age are a requirement. Custom orthotics can reduce excessive motion in joints causing the deformity and significantly slow the progression at times preventing surgery. Better shoe gear is important as well. Our teenage girl population right now prefers to wear either dance slippers or high heeled shoes, both of which are contributing factors to the deformities worsening often needing surgery. So just wearing a good shoe can mean a world of difference.
If you think your child may have this deformity or this runs in your family and you want to know if it can be prevented, please bring them in for an evaluation. And the sooner the better!
For more information of juvenile bunions and other kid's foot deformities click here!
Bunions are most commonly inherited. The foot type that causes the deformity is passed down through the generations and can be seen as early as the age of 6. This is when the bones of the arch have fully formed and children are continuing to do more things like run, jump and play.
The deformity is a bump seen at the big toe joint that can be painful with tight shoes or no shoes at all. It can also be painful with increased activity and often barefoot walking causes arch pain or ball of foot pain because of the improper mechanics causing the bunion to form.
So how do you know if your child has a bunion? If you see a bump, most likely that’s what it is. But your best option is to have them evaluated by a foot and ankle specialist who is trained to diagnosis this condition. Xrays should be performed to see if the bones are growing properly. A biomechanical exam will show why the bunion is forming.
Most of the time treatment begins with conservative care and orthotics at this age are a requirement. Custom orthotics can reduce excessive motion in joints causing the deformity and significantly slow the progression at times preventing surgery. Better shoe gear is important as well. Our teenage girl population right now prefers to wear either dance slippers or high heeled shoes, both of which are contributing factors to the deformities worsening often needing surgery. So just wearing a good shoe can mean a world of difference.
If you think your child may have this deformity or this runs in your family and you want to know if it can be prevented, please bring them in for an evaluation. And the sooner the better!
For more information of juvenile bunions and other kid's foot deformities click here!
Monday, March 16, 2009
Girls on The Run In Southlake Texas!
My 11-yr-old daughter, Alex, and I have been participating in “Girls on the Run” at her school, Durham Intermediate, in Southlake. The program has given us the opportunity to run together and share a moment in time that has been very special. She is learning more about her body and having open discussion about it with me! I encourage all women who run to share their love of exercise with their daughters. Fourth, Fifth and Sixth grade level is ideal.
Studies show that girls between the ages of eight and twelve are still receptive to adult influence, while beginning to feel peer pressure. It's an age psychologists call the latency period of development when girls begin to confront important life and relationship issues. As a prevention program, Girls on the Run initiates healthy decision making about difficult issues and really talking to their parents/caretakers before it's too late.
In addition, learning healthy exercise habits early in life increases the chances that participants will value their own physical fitness as adults. Recent studies show that only those who develop exercise habits in their teen years or earlier are likely to maintain those habits for life. It's well documented that regular, moderate exercise improves cardiovascular functioning, and reduces the risk of developing breast cancer, osteoporosis (brittle bones), and obesity. In addition, girls of this age are more open to the positive peer influences, positive adult role models and the confidence enhancing which are all parts of the GOTR experience.
Many moms have posed the question, “Is it safe for my young daughter to run that far?”
"Children's bodies are well suited for endurance exercise, and numerous studies have shown that children show many positive physiological adaptation to endurance exercise training. The keys are gradual progression and common-sense adult supervision. If those conditions are met, running 3 miles is a reasonable goal for most young people."
from Russell R. Pate, Ph.D. with the Department of Exercise Science at the University of South Carolina
If you are interested in the program, contact Girls on the Run. If you want to join us for the local race this year you can register on-line:
GOTR of DFW Metroplex
4/25/09 @ 8:00a.m. – New Balance Girls on the Run 5K
Address of Event:Andrew Brown Park W 360 N Denton Tapp Road Coppell, TX
Share your love of running with your child….it may make the difference of their lifetime!
Studies show that girls between the ages of eight and twelve are still receptive to adult influence, while beginning to feel peer pressure. It's an age psychologists call the latency period of development when girls begin to confront important life and relationship issues. As a prevention program, Girls on the Run initiates healthy decision making about difficult issues and really talking to their parents/caretakers before it's too late.
In addition, learning healthy exercise habits early in life increases the chances that participants will value their own physical fitness as adults. Recent studies show that only those who develop exercise habits in their teen years or earlier are likely to maintain those habits for life. It's well documented that regular, moderate exercise improves cardiovascular functioning, and reduces the risk of developing breast cancer, osteoporosis (brittle bones), and obesity. In addition, girls of this age are more open to the positive peer influences, positive adult role models and the confidence enhancing which are all parts of the GOTR experience.
Many moms have posed the question, “Is it safe for my young daughter to run that far?”
"Children's bodies are well suited for endurance exercise, and numerous studies have shown that children show many positive physiological adaptation to endurance exercise training. The keys are gradual progression and common-sense adult supervision. If those conditions are met, running 3 miles is a reasonable goal for most young people."
from Russell R. Pate, Ph.D. with the Department of Exercise Science at the University of South Carolina
If you are interested in the program, contact Girls on the Run. If you want to join us for the local race this year you can register on-line:
GOTR of DFW Metroplex
4/25/09 @ 8:00a.m. – New Balance Girls on the Run 5K
Address of Event:Andrew Brown Park W 360 N Denton Tapp Road Coppell, TX
Share your love of running with your child….it may make the difference of their lifetime!
Saturday, March 14, 2009
Grapevine Southlake Soccer Moms Want to Know!
This weekend was the beginning of another recreational soccer season for the Grapevine Southlake Soccer Association. Unfortunately it was rained out! But that didn't keep my phone from ringing. Moms want to know why their kids feet hurt after only a few weeks of practice. Why does my child run funny? My daughter asked me if anyone ran normally after listening to me talk to lots of other moms. Good question!
Let's take a closer look. Your heel swings from side to side as your foot moves. When the heel swings correctly, your foot can flatten and regain its arch as you walk. (normal pronation with resupination) But if your heel swings too much, your foot may flatten more than it should. (overpronation) Over time, such excess movement causes many foot problems. And yes, some people do walk normally, but not many.
When the heel hits the ground, its outer edge touches first. Soft tissues (muscles, tendons and ligaments) relax. Your foot is able to flatten, adapt to uneven surfaces, and absorb the shock of touchdown.
During midstance, your heel is below the anklebone, and the front and back of your foot are aligned. Your foot easily bears your weight.
As the heel lifts, it swings slightly to the inside. Muscles, tendons, and ligaments tighten. Your foot regains its arch, allowing your toes to push your weight off the ground.
Too Much Movement Causes Strain!
When your foot flattens too much (overpronation), some bones are forced to support too much weight. The muscles pull harder on these areas, making it more difficult for tendons and ligaments to hold bones and joints in place. Over time, you may develop swelling or pain on the bottom of your foot or near the heel. When your foot flattens too much, the ankle and heel do not align during midstance. The foot strains under your body's weight. This aggrevates the growth plates and makes kid's have foot pain.
Abnormal biomechanics causes overpronation. This is easily controlled with a custom orthotic. That is why most biomechanical foot pain and deformities are treated conservatively with custom orthotics. Change the biomechanics, decrease the stress and take care of the pain from the strain.
Custom orthotics coupled with vigorous stretching can make your child walk as close to normally as possible. Some kids still run a little funny due to the growth process, but at least when aligned they don't strain and won't complain of pain!
So soccer moms, if your child runs funny and is complaining of foot, ankle, knee, leg or back pain....it definately can be their feet. Let's check them out before the season becomes a wash!
Let's take a closer look. Your heel swings from side to side as your foot moves. When the heel swings correctly, your foot can flatten and regain its arch as you walk. (normal pronation with resupination) But if your heel swings too much, your foot may flatten more than it should. (overpronation) Over time, such excess movement causes many foot problems. And yes, some people do walk normally, but not many.
When the heel hits the ground, its outer edge touches first. Soft tissues (muscles, tendons and ligaments) relax. Your foot is able to flatten, adapt to uneven surfaces, and absorb the shock of touchdown.
During midstance, your heel is below the anklebone, and the front and back of your foot are aligned. Your foot easily bears your weight.
As the heel lifts, it swings slightly to the inside. Muscles, tendons, and ligaments tighten. Your foot regains its arch, allowing your toes to push your weight off the ground.
Too Much Movement Causes Strain!
When your foot flattens too much (overpronation), some bones are forced to support too much weight. The muscles pull harder on these areas, making it more difficult for tendons and ligaments to hold bones and joints in place. Over time, you may develop swelling or pain on the bottom of your foot or near the heel. When your foot flattens too much, the ankle and heel do not align during midstance. The foot strains under your body's weight. This aggrevates the growth plates and makes kid's have foot pain.
Abnormal biomechanics causes overpronation. This is easily controlled with a custom orthotic. That is why most biomechanical foot pain and deformities are treated conservatively with custom orthotics. Change the biomechanics, decrease the stress and take care of the pain from the strain.
Custom orthotics coupled with vigorous stretching can make your child walk as close to normally as possible. Some kids still run a little funny due to the growth process, but at least when aligned they don't strain and won't complain of pain!
So soccer moms, if your child runs funny and is complaining of foot, ankle, knee, leg or back pain....it definately can be their feet. Let's check them out before the season becomes a wash!
Sunday, March 1, 2009
Does Your Child Have Heel Pain?
Heel Pain in Kids:
My child is limping, complaing of pain in the back and bottom of their heels. My child is not as active as they normally are, they are even running and walking differently!! It almost seems like they are walking on their toes. What is going on?? They even told me it feels like bones are sticking out of their feet!
Your child could be suffering from calcaneal apophysitis. Also known as Sever's disease. It is not really a disease, it is actually an inflammation of the growth plate within the heel. Most commonly occuring in children ages 8-14, the growth plate can get irritated and inflammed, often due to repetitive stress.
If you have noticed any of these signs/symptoms in your children, there are some easy ways to relieve their pain and get them back to activity. Commonly gel heel cushions, orthotics, supportive gym shoes, anti-inflammatories and rest from activity can help relieve the pain. If the pain lasts or becomes more intense you should seek medical attention from a podiatrist. Many other things could be going on in the foot that could be causing their pain. For more information about pediatric heel pain and other disorders in your childs feet click here.
My child is limping, complaing of pain in the back and bottom of their heels. My child is not as active as they normally are, they are even running and walking differently!! It almost seems like they are walking on their toes. What is going on?? They even told me it feels like bones are sticking out of their feet!
Your child could be suffering from calcaneal apophysitis. Also known as Sever's disease. It is not really a disease, it is actually an inflammation of the growth plate within the heel. Most commonly occuring in children ages 8-14, the growth plate can get irritated and inflammed, often due to repetitive stress.
If you have noticed any of these signs/symptoms in your children, there are some easy ways to relieve their pain and get them back to activity. Commonly gel heel cushions, orthotics, supportive gym shoes, anti-inflammatories and rest from activity can help relieve the pain. If the pain lasts or becomes more intense you should seek medical attention from a podiatrist. Many other things could be going on in the foot that could be causing their pain. For more information about pediatric heel pain and other disorders in your childs feet click here.
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