Introduction:
Foot health is a critical and influential parameter in both pediatric and adult populations. Certain foot problems arise right from a younger age and, if left unattended, may impair the leg's functionality. When encountered and treated at the right time, minor issues concerning the foot can hinder permanent deformities and impairments. Certain self-correcting foot irregularities may be elicited during a specific age and later resolved without medical intervention. Self-correcting foot issues need to be identified and distinguished from the other forms of pediatric foot problems. Considering all forms of pediatric foot issues as self-correcting can potentially bring down the treatment scope for tackling the foot condition, which could directly reflect their quality of life and general well-being.
What Are the Common Pediatric Foot Problems?
Pediatric foot problems encompass a spectrum of conditions that typically involve the foot. Some of the frequently encountered pediatric foot problems include the following:
1. Bow Legs: It is a specific foot condition exhibited within 18 months of age. The legs, particularly below the knee, arch outward, giving rise to a potential gap between the two legs below the knee level while in the upright position. This is considered to be a physiological foot problem, which resolves by the time the child attains the age of two years. But at times, the condition may persist, which can be associated with vitamin D insufficiency. Severe bowing or arching of the legs are the manifestations of rickets, a condition elicited by collapsed vitamin D levels. Therefore, it is advised to be watchful for the resolution of the bow legs. Persistent arching necessitates immediate medical intervention to check further leg deformities and functional impairment of the legs.
2. Pigeon Toes: Babies' legs exhibit a turned-in appearance and are considered pigeon toes. It is another physiologic condition, and the inward turning corrects itself once the child starts walking and running. In most instances, it gets completely resolved by eight years. If it persists even after age eight, orthopedic intervention can be sought to tackle it. Though pigeon toes do not bring about functional impairment, they can give rise to embarrassing and awkward walking patterns, which can be fixed with appropriate interventions at the right time.
3. Knock Knees: Knock knees are another peculiar condition. When standing with both knees in close approximation, the ankles fail to be in close approximation and instead hold a potential gap between them. It is frequently encountered in the three to six age group and tends to be rectified by around seven. If it persists, it can bring about soreness and puffiness in and around the knees. Specialist consultation is recommended in such cases to tackle the condition and to check further progression.
4. Toe Walking: Babies under two or three tend to exhibit toe walking, where only the toe tip and footballs contact the ground while walking. It is normal when elicited until three years, but if the child fails to outgrow it, there are possibilities for stiffened ligaments or muscles in the calf region. Babies with certain neurological problems may also precipitate toe walking in the later stages. Therefore, monitoring the child’s growth and walking pattern throughout the various developmental stages is advised to ensure that physiological corrections are happening within the stipulated age. Children who flag impaired intellectual development are also encountered with toe walking.
5. Flat Foot: The absence of the foot arch is denoted by the term flat foot, where the undersurface of the foot elicits a flat appearance and makes more contact with the ground in an upright position. The flat foot is the condition, which the babies are born with. Arching of the foot develops progressively as the baby grows. Within six years, the child completely outgrows the flat foot. However, there are instances of persisting flat feet that are more or less linked to familial association. The flat foot does not potentially impede the leg’s functional status. However, it can be modulated by incorporating orthopedic shoes to enhance the foot arching.
6. Sever’s Disease: An orthopedic condition routinely encountered in children, particularly those undergoing rapid growth. In Sever’s disease, the child may elicit soreness primarily in the heel region. The bone plate present in the heel region will be irritated and disturbed by the exaggerated pulling force exerted by the Achilles tendon. It is frequently reported in children actively engaged in sportive events, making the heel bone plate susceptible to the Achilles tendon’s pulling force.
7. Plantar Fasciitis: It is another condition that can precipitate as heel pain. Plantar fasciitis, as the name suggests, is brought about by plantar fascia’s irritation and inflammation. The connective tissue belt that bridges the toe to the heel is named plantar fascia. Exaggerated pain is typically felt during the initial footsteps upon arousing from the bed. Both children and adult individuals can get plantar fasciitis.
What Are the Treatment Possibilities for Pediatric Foot Problems?
Not all pediatric foot problems mandate therapeutic attention. The majority of the conditions resolve upon further growth. However, conditions like plantar fasciitis and Sever’s disease necessitate appropriate therapy to ease the soreness and associated discomfort. It is necessary to keep the parents updated and aware of the physiological and transient foot issues, which aids in detecting deviations from what is identified as normal. Certain self-correcting foot issues, if persist for more than the intended duration, warrant therapeutic attention and appropriate orthopedic intervention to maintain the functional status of the feet. Physical therapies and orthopedic devices are promising therapies concerning pediatric foot problems. Physical therapies enhance and augment foot muscle strength and support structures like tendons. In the case of heel pain, a cold pack and heel cup inserts are advised to curb the tenderness.
Conclusion
Pediatric foot problems are often left unattended, considering all of them as self-correcting. Though a major proportion of pediatric foot problems resolves over time, keeping a close watch on the severity of the foot problems is mandatory. It is better advised to seek guidance from the concerned medical professionals. The parents need to be keen on each step of the child’s growth. Foot problems may compromise the child’s social activities and keep them withdrawn. The child’s reluctance to sportive events and frequent and unusual falling are indications of underlying foot problems. However, there are promising therapies for pediatric foot problems when detected at the right time. Therefore, understanding what is normal and abnormal for a child’s age is imperative to ensure prompt and timely diagnosis.
