Foot Problems in Children Parents Should Watch For Gotham Footcare

Children are constantly growing, developing, and exploring the world through movement. From their first wobbly steps to running around on the playground, healthy feet are essential to a child’s development and mobility. However, foot problems in children are not uncommon and can sometimes be difficult to detect. Many pediatric foot conditions develop gradually and may be mistaken for growing pains or dismissed as a phase that the child will outgrow.

Early identification and intervention are key. Left unaddressed, some childhood foot issues can lead to long-term complications, including impaired walking patterns, chronic pain, and difficulties with physical activities. Parents play a vital role in observing and recognizing signs of foot problems early on. This blog aims to guide parents through the most common pediatric foot conditions, their symptoms, and when professional help is necessary.

Flat Feet

Flat feet, or pes planus, is one of the most commonly observed foot conditions in children. All babies are born with flat feet due to the presence of a fat pad that hides the arch. As children grow, the arch begins to develop, usually becoming more prominent by age six or seven. However, some children never develop a visible arch and maintain a flat-footed posture into adolescence or adulthood.

Flexible flat feet are generally not painful and often resolve without intervention. The arch may appear when the child stands on their tiptoes but disappears when they stand flat. However, if flat feet are associated with pain, fatigue, or difficulty walking, they may require medical evaluation. Rigid flat feet, where the arch is absent even when the child stands on tiptoes, could indicate a structural abnormality such as tarsal coalition and may necessitate imaging studies.

Management depends on the severity of symptoms. Custom orthotics, physical therapy, or supportive footwear can help alleviate discomfort. Surgery is rarely needed unless there is significant structural deformity or chronic pain.

In-Toeing and Out-Toeing

In-toeing, commonly known as “pigeon toes,” is when a child’s feet point inward while walking or running. Out-toeing is the opposite, where the feet point outward. Both conditions can be part of normal development and may resolve with age. In-toeing is often caused by femoral anteversion (inward twisting of the thigh bone), tibial torsion (twisting of the shinbone), or metatarsus adductus (curving of the foot).

Out-toeing may be due to external rotation of the hip or loose ligaments. In most cases, children with these gait patterns do not experience pain and maintain normal function. However, if the abnormal gait persists beyond age eight, worsens over time, or is accompanied by pain, it should be evaluated.

Observation is often the first line of management, as many children outgrow these patterns. Stretching exercises, physical therapy, and in rare cases, bracing or surgery may be considered depending on the severity and underlying cause.

Toe Walking

Toe walking is common in toddlers who are just learning to walk. It typically resolves by the age of three. Persistent toe walking beyond this age can be a sign of underlying issues such as tight Achilles tendons, neuromuscular disorders like cerebral palsy, or autism spectrum disorder.

Children who continue toe walking past the typical age may develop shortening of the calf muscles or other gait abnormalities. Parents should observe whether their child can stand with their heels flat and whether the toe walking is consistent or occasional. If the child toe walks most of the time and cannot put their heels down, a medical evaluation is warranted.

Treatment may include physical therapy to stretch and strengthen muscles, night splints to promote heel contact, or in some cases, casting. If an underlying neurological condition is suspected, referral to a specialist is essential.

Sever’s Disease

Sever’s disease, or calcaneal apophysitis, is a common cause of heel pain in active children, particularly those aged 8 to 14. It results from inflammation of the growth plate in the heel, where the Achilles tendon attaches. The condition often develops in children involved in sports that require running or jumping.

Symptoms include heel pain, limping, tenderness at the back of the heel, and difficulty walking after physical activity. The pain typically worsens with activity and improves with rest. Sever’s disease is not a true disease but a growth-related overuse injury.

Management focuses on reducing pain and inflammation. Rest, ice, stretching exercises, supportive shoes, and heel cushions can be very effective. Most children recover fully with conservative treatment. Education on activity modification and proper footwear is essential to prevent recurrence.

Ingrown Toenails

Ingrown toenails occur when the edge of the toenail grows into the surrounding skin, causing redness, swelling, and pain. This condition commonly affects the big toe and can result from improper nail trimming, tight footwear, or trauma.

In children, ingrown toenails can be particularly painful and may lead to infection if not treated promptly. Parents should look for signs such as reluctance to wear shoes, limping, or visible inflammation around the nail.

Mild cases can be managed at home by soaking the foot in warm water, gently lifting the nail edge, and applying antibiotic ointment. Severe cases or infections require professional care, which may involve partial nail removal. Preventive measures include proper nail trimming, wearing well-fitted shoes, and keeping feet clean and dry.

Plantar Warts

Plantar warts are small growths caused by the human papillomavirus (HPV) and typically appear on the soles of the feet. They may resemble calluses but often have tiny black dots in the center. Children can contract HPV from walking barefoot in communal areas like pools, locker rooms, or gyms.

Plantar warts can be painful, especially when located on weight-bearing areas. Children may complain of pain while walking or show signs of favoring one foot. Though some warts resolve on their own, treatment may be necessary if the wart is painful, spreading, or persistent.

Options include topical treatments, cryotherapy, or prescription medications. Preventive strategies include encouraging children to wear flip-flops in communal areas and practicing good foot hygiene.

Athlete’s Foot

Athlete’s foot is a fungal infection that causes itching, burning, and redness between the toes or on the soles of the feet. Though more common in adolescents and adults, children can also develop athlete’s foot, particularly if they have sweaty feet or share shoes.

The condition is contagious and can spread through direct contact or contaminated surfaces. Symptoms may include peeling skin, cracking, or a scaly rash.

Treatment typically involves antifungal creams or powders. Keeping feet clean and dry, changing socks daily, and avoiding walking barefoot in public areas can prevent recurrence. If symptoms do not improve, medical evaluation is necessary to rule out bacterial infection or other skin conditions.

Overpronation

Overpronation refers to the excessive inward rolling of the foot during walking or running. While some degree of pronation is normal, overpronation can strain muscles and ligaments, leading to pain in the feet, ankles, knees, or hips.

Children with overpronation may have a collapsed arch and uneven shoe wear. They might also complain of tired legs, balance issues, or difficulty keeping up with peers.

A podiatrist or pediatrician may recommend orthotics, supportive footwear, and strengthening exercises to improve alignment and reduce strain. Early intervention can prevent future joint problems and improve overall mobility.

Clubfoot

Clubfoot is a congenital condition where one or both feet are turned inward and downward. It is typically identified at birth and requires prompt treatment to ensure normal foot function.

Without intervention, clubfoot can lead to significant mobility issues. The Ponseti method, which involves gentle manipulation and serial casting, is the standard treatment approach. Most cases respond well to this method and may also require a brace to maintain correction.

Parents play a crucial role in ensuring compliance with treatment and follow-up care. With proper management, children with clubfoot can achieve normal function and participate in typical activities.

Growing Pains or Something More?

Parents often dismiss foot or leg pain in children as growing pains, especially when it occurs at night or after physical activity. While growing pains are common and typically harmless, persistent or localized pain may indicate an underlying issue.

Children who consistently complain of foot discomfort, limp, or avoid activities should be evaluated by a healthcare professional. Early diagnosis allows for timely treatment and prevents potential complications.

Tips for Monitoring Your Child’s Foot Health

Regular foot inspections can help parents identify issues early. Look for signs such as swelling, redness, abnormal gait, or changes in nail or skin appearance. Pay attention to complaints of pain, limping, or reluctance to participate in physical activity.

Encouraging proper footwear is essential. Shoes should fit well, provide arch support, and allow room for growth. Children’s feet grow rapidly, so regular measurements and shoe replacements are necessary.

Teaching children about foot hygiene is also important. Daily washing, drying between the toes, and wearing clean socks can prevent infections and promote healthy foot development.

When to See a Specialist

Not all foot concerns require specialist care, but certain signs warrant evaluation by a pediatrician or podiatrist. These include:

• Persistent pain or swelling
• Abnormal gait that doesn’t improve
• Structural deformities
• Signs of infection
• Delayed walking milestones

A specialist can perform a comprehensive assessment and recommend appropriate treatment, whether it involves observation, therapy, orthotics, or more advanced interventions.

Conclusion

Healthy feet are the foundation for a child’s mobility, independence, and physical development. While many pediatric foot conditions are harmless and resolve naturally, others can impact long-term function if not addressed. Parents are in the best position to observe changes in their child’s gait, behavior, or comfort.

By staying informed and attentive, parents can recognize early signs of trouble and seek help when needed. Whether it’s flat feet, ingrown nails, or gait abnormalities, timely intervention ensures that children can move confidently and comfortably through every stage of growth. Contact our Gotham Footcare team at (212) 921-7900.