Children's Feet and Sports Injuries

Children and Adolescents' feet and limbs are at risk of different sports injuries compared to adults. This is mainly because their bones are still developing and growing.

It is estimated that approximately 40% of all children's injuries aged 5-14 years are sports-related*.

*stanfordchildrensorg

The most injuries in sports in 2020 came from

Basketball
Football

Soccer
Netball

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Important factors in increasing the rate of sports injuries in children

There are some important factors that Helen believes may contribute to the increasing rate of sports injuries in children that she observes in her rooms in recent years.

More children are participating in competitive sports.

Children's sport has become increasingly popular throughout the latest generation of youths. 30 years ago, children's sport was most commonly played in schools and as part of recreational play.

The children of today are kept busy, and so are us parents. Driving them to and from various activities, training sessions and matches, and tournaments.

The typical child of today is commonly a member of multiple sporting teams and participates in several training sessions followed by matches within the same week.

Changes in recreational activity

The lifestyle of today's youth is different from previous generations.

Today our children, whilst they are commonly playing more sport in a competitive environment than previous generations, are also participating in less active recreational play. Often sitting in front of computers, electronic gaming devices, and mobile phones for hours on end every day.

It is this frequent and sudden transition from sitting in a commonly crouched up inactive position, to a sudden burst of activity; like playing a high-intensity game of indoor soccer, that can further influence the likelihood of injury and /or pain.

Adequate muscle flexibility and strength are important factors in injury prevention in our children as well as adults.

With all this in mind, having your child's feet and lower limb assessed to identify any potential issues early, is highly recommended. Furthermore, it is more beneficial for your child than waiting for symptoms to develop and potentially cause pain and harm.

The bones in a child's foot are not fully developed from cartilage to bone until around 5 years of age

Throughout childhood and adolescence, there are many periods of rapid growth during which the bones elongate and enlarge.

Several external and internal factors can place these growth plate areas under excessive strain and potentially lead to pain, injury or damage.

External factors include repetitive stress caused by jumping and sudden force like a fall.

Internal factors include muscle tightness like tight calf muscles and various biomechanical conditions like "flat feet" for example.

The main causes of injury can be divided into 2 main categories:

Macrotrauma - a single traumatic event
Microtrauma - repetitive or overuse injuries eg. jumping

What you can expect from a podiatry assessment for your child:

Helen will assess your child's:

Gait (walking) via video gait analysis
Muscle strength
Muscle flexibility
Reflexes
Footwear (school and sports)
Range of motion in feet, ankles, knees, and hips

An individual recommended treatment plan will be formulated for your child based on the results of the assessment.

Common treatment plans include:

Foot orthotics
Footwear assessment, advice, and referral
Stretching, strengthening, and conditioning programs
Taping
Activity and training modifications

Exercise programs are often an integral part of the treatment plan

The exercise program prescribed for your child is provided in an easy-to-follow video format which is emailed to you and can be accessed from your phone, tablet, or computer.

Feedback from parents has been positive and this modern format greatly improves compliance and ultimately, results.

Being a parent of 3, Helen fully appreciates the challenges facing busy families these days. She, therefore, tries to make all treatment plans as easy and relevant as possible. So that eventually, children can do a lot of the therapy themselves without too much input from parents.

Helen will guide you and your child through each step and follow up regularly to assess the progress as your child grows.

Some common children's lower limb conditions include:

Sever's Disease

Often presents as heel pain and is a common overuse injury.

Poor foot posture and muscle flexibility are often significant contributing factors that should and can be addressed for recovery.

Toe walking

"Tiptoe walking" as it is often known has many causes and is relatively common in children.

Some causes are quite simple, like a bad habit, and can be remedied easily.

Other causes are more complicated and can involve tight calf muscles, cerebral palsy, muscular dystrophy, or autism.

Ingrown toenails

Often uncomfortable and painful, ingrown toenails occur when the edges or corner of the nail grows into the skin next to the nail. This leads to pain, redness, swelling, and sometimes infection.

There are several causes. Effective treatment should address the underlying cause in order to prevent reoccurrence.

A significant number of ingrown toenails in youths are caused by incorrect toenail cutting. Once treated and educated on correct cutting, these usually have a great outcome.

Other causes include genetic factors, tight footwear, poor foot posture, excessive fluid, toenail injury, or infection.

Severe cases can be remedied with a small surgical procedure involving a local anesthetic and the subsequent surgical removal of the side of the nail. The area is cauterized using a chemical that ensures the side of the nail does not grow back. Helen will continue to redress and monitor the area until healed.

Ankle sprains and instability

Ankle sprains are relatively common sports injuries in children.

More concerning is that about 20% of acute ankle sprains will develop into chronic ankle instability*.

*(CAI) potentially leading to ongoing issues. (Al-Mohrej OA, AL Kenani NS. Chronic ankle instability: Current perspectives, Avicenna journal of medicine 2016 Oct;6(4):103)

Testing your child for ligament laxity and working on improving muscle weakness, proprioceptive deficits, and postural control; are all important and powerful tools to treating and preventing ankle sprains and generally "weak ankles".

Flat feet

The technical term for flat feet is "Pes Planus" and refers to the condition where the arch of the foot fails to develop or collapses. Meaning that the inside surface of the foot is very close or in contact with the ground when standing.

It is worth noting that not all "flat feet" require intervention. However, it is important to have them properly assessed as many children with this foot posture can suffer from symptoms and long-term complications from this condition if left unattended.

In toeing and out toeing

In-toeing refers to a walking pattern where the child's feet are turned inwards.

Out toeing is when a child walks with the feet turned outwards.

Both conditions should be assessed properly by a Podiatrist, as both can lead to long-term problems if they persist beyond a certain age or are excessive in their degree.

There are specific developmental milestones throughout a child's life that Helen will check for to determine if intervention is needed.

Generally speaking, by the age of 4 a child's foot and walking should start to develop adult-like characteristics and movements.

Warts

These lesions are the result of an all too common virus that is most often contracted in communal wet areas like swimming pools.

Warts can be uncomfortable and persistent. They are also contagious and can spread to other members of the family. Proper assessment and treatment are important.

Helen offers a range of effective and painless treatment options tailored to each individual client's circumstances.

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