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. What, now in the literal sense, causes our kids to drag their feet?
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).
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.
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 a fracture to this sesamoid bone.
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 supinates (hi arch) more than normal.
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 early. A quicker treatment means a more successful treatment so get them checked out early: pediatrician, urgent care, or go straight to the foot and ankle specialists.
- This is tough for multi-sport athletes, but if caught early, a brief rest can get them out of trouble.
- Anti-inflammatory. Ice, Motrin/Advil/Aleve, homeopathic Traumeel, can be of help.
- Physical therapy.
- Boot or cast.
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 that are too tight by 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 are a common problem for kids, a virus that sets up in the bottom of the foot. 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 zap the bounce in our kid’s step and causes them to drag their feet around. We love to help kids and welcome you at the University Foot & Ankle Institute where we are well equipped to evaluate and offer treatments to promote a quick and full recovery. Go Kids!
Upon graduation in 2001, Franson accepted a three-year residency program at the Greater Los Angeles VA and UCLA County Hospital.
Dr. Franson specializes in several areas including total ankle replacement and sports medicine.
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