Lower Limb and Foot Problems
Children can be affected by poor biomechanics just as adults can. Poor biomechanics in children can result in the following lower limb and foot problems:
Heel Pain – Sever’s Disease (Calcaneal Apophysitis)
Usually occurring between the ages of 10 and 14, Sever’s Disease is more common in boys than girls. Sever’s Disease is a disturbance to the growth plate at the back of the calcaneus (heel) where the strong Achilles tendon attaches. The growth plate at the heel seals up when a child stops growing.
• Pain, swelling and redness at the back of the heel
• Limited mobility
Knee Pain – Osgood-Schlatter’s Disease
Osgood-Schlatter’s disease is a condition that affects the insertion of the patellar tendon at the tibial tuberosity and is one of the most frequent causes of knee pain in children. The condition occurs most commonly in children between the ages of 10 and 15 but it can occur in younger children. It is more common in boys but girls are also susceptible to its debilitating effects.
• Pain, swelling and tenderness just below the knee joint
• Many children first signal the start of the problem by rubbing the top of their “shinbones” with their hands
Juvenile Rheumatoid Arthritis (JRA)
Usually seen in children under the age of 16, Juvenile Rheumatoid Arthritis (JRA) is the most prevalent form of juvenile arthritis. JRA is an autoimmune disorder, which means the body mistakenly identifies some of its own cells and tissues as foreign.
• Persistent joint swelling, pain, redness and joint contracture/stiffness
• Possible growth problems
• Limited mobility, morning stiffness
• Growth in affected joints may be too fast or too slow, causing one leg or arm to be longer than the other
- Foot and lower limb exam
- Custom-made foot orthotic or over-the-counter device
- Modification of footwear
- Recommendation for appropriate and proper-fitting footwear
For some diseases or injuries affecting children’s lower limbs, time and rest are the most important factors in the recovery process as the condition will self-resolve as the child grows. During this time, measures that can be taken to help decrease pain until healing occurs include:
- For Sever’s Disease – adding heel lifts to shoes to help lessen the strain on the back of the heel
- For Osgood Schlatter’s Disease – ensuring the foot is in optimal alignment and not causing undue rotation of the lower leg nor stress to the tibial tuberosity (the bony protrusion at the top of the tibia bone in the lower leg located just underneath the kneecap)
- For Juvenile Rheumatoid Arthritis – accommodating painful joints, by using softer materials in orthotics and selecting appropriate footwear
- Buying shoes that fit perfectly. It is not a good idea to buy shoes that a child will “grow into.” A shoe that is too big allows for a sloppy fit and poor support which may aggravate problems
- Not using hand-me-down shoes for children as the wear patterns already created by previous owners will not allow for the best support possible for the child
- Canadian Certified Pedorthists may recommend an over-the-counter device or a custom-made foot orthotic to help relieve pain caused by injury or unusual alignment of the bones of the foot
Footwear is a key component for anyone dealing with lower limb pain and injury and your Canadian Certified Pedorthist can help determine an appropriate style and fit for your child’s condition.