Posted by: The Vancouver Sun
Jesse Heinz, 16, was prescribed shoe inserts four years ago and saw improvements within a year.
Photograph by: Bruce Stotesbury, For Postmedia News
When Lorelee Heinz saw that her son Jesse, then about 12, was falling behind on the soccer field, she looked beyond the obvious. The boy was a little heavy and his knees were angling inward slightly. So, Heinz had his feet checked by a podiatrist, who prescribed shoe inserts to assist with the boy’s flat feet.
Within a year, Jesse developed arches in his sole. His legs have since straightened. Now at 16, he’s a fitness nut willing to try anything. "It absolutely helped him immensely," said the Saanich woman. But Heinz is a bit of an exception. Parents, who are so often vigilant about things like their children’s teeth, willing to resort to braces to achieve that perfect smile, will often overlook their kids’ feet.
"It’s quite common for children to get their teeth, their hearing and their eyes examined," said Victoria podiatrist Dr. Marshall Baer. "But they don’t routinely get their feet examined." But the feet of our children undergo transformations and growth every bit as profound as the development of their teeth.
The foot, according to the B.C. Podiatric Medical Association, is one of the most complicated parts of the body, with 26 bones, wrapped up with ligaments, muscles, blood vessels and nerves. Within just the first year of a baby’s life, the foot will develop to reach almost half its adult size.
According to Dr. Ron Fisher, a physical medicine and rehabilitation specialist at the Queen Alexandra Centre for Children in Saanich, children’s feet are constantly changing all the way through their teens. "The foot structure is so complicated," said Fisher. "And there is an awful lot of things that can go wrong and a lot we can improve upon, in particular, if we catch things early enough."
Gym class in school and team sports like soccer, where the foot is flexing and being stressed, are good places to watch for a child’s foot problems. Things to watch out for include whether children are refusing to participate in activities they once enjoyed, or whether they’re keeping up with their peers or falling behind. And at any time, if a child complains of pain in their feet, it should be examined by their family doctor or a specialist.
Fisher recalls one young patient, a seven-year-old girl, who was unable to keep up in gym class, falling behind and feeling bad about herself. But it wasn’t until her mother pressed her that she revealed that her feet hurt — by the time she finished the class, she just couldn’t run anymore. "She had a legitimate problem," said Fisher. "She had some ligament problems in her foot and needed a support and she should be perfectly fine. "And she’ll probably outgrow that and she probably won’t need orthotics or special shoes once her feet have fully matured," he said.
Fisher said it’s important for parents to be aware and ask their children questions about their feet. Are they hurting? Are your ankles sore? Are you having trouble running?
A visit to a doctor or a foot specialist can usually determine whether the problem is real. Examination with tools such as X-rays can usually detect an issue like fused bones that might require surgery. He said improperly formed feet can lead to a large number of adult health problems.
Those can include problems with ankles, knees, hips and back as the foot fails to properly support the weight of the body. He’s even seen one case of chronic headaches traced to foot deformities. But Fisher is also cautious about aggressively screening children for foot problems. Surgery can lead to a lifetime of medical intervention. And very often, issues can be misidentified as problems when they are really just normal development.
For example, flat feet in children are, for him, usually no cause for concern. Fisher said all children start with flat feet — they don’t begin to develop an adult arch until they are six to 10 years old and it will continue to develop into their teens. Then as people pass into senior years, the feet usually flatten out again.
Nevertheless, he said, he is perfectly happy to hear from parents concerned enough to seek medical advice about their children’s flat feet. "That’s perfectly fine; at least they noticed something and they probably read an article or saw something on TV," he said.
Victoria podiatrist Dr. Martin Cole is also cautious about flat feet, saying only a foot specialist should identify them as a problem. But in general, foot problems treated early can prevent an adult life of problems throughout the body, said Cole.
"A lot of times, they will end up having to have orthotics or devices when they are in their 20s," he said. "(But) if you catch an early deformity and you can just put something in their shoe at the right time, you will keep their cartilage aligned in their knees and their back as they grow up."
Signs of trouble
The American College of Foot and Ankle Surgeons lists five warning signs a child may be experiencing foot problems.
- Your child complains of pain.
It is never normal for a child to have foot pain. Injuries can seem minor, but if pain or swelling lasts more than a few days, the child’s foot should be examined by a physician.
- Your kids can’t keep up with peers.
If children lag behind in sports or backyard play it may be because their feet or legs are tired. Muscles in the feet and legs tire easily if feet are not functioning well.
- Your kids voluntarily withdraw from activities they usually enjoy.
If they are reluctant to participate it may be due to heel pain, a problem typically seen in children eight to 14. Repetitive stress from sports may cause muscle strain and inflammation.
- They don’t want to show you their feet.
Children may feel pain or notice a change in the appearance of their feet or toenails but say nothing because they fear a trip to the doctor’s office. Parents should regularly inspect their children’s feet, looking for calluses, growths, discoloured skin or redness or swelling around the toenails.
- Your child often trips or falls.
Repeated clumsiness may be a sign of in-toeing, balance issues or neuromuscular conditions.
Please call the Foot, Ankle & Lower Leg Center office in Las Vegas anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you. Please visit our website @ FallCenter.com or www.walkwithdiabetes.com. The Foot, Ankle & Lower Leg Center has Diagnostic imaging: Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.
Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures. In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries. This cutting edge technology enables patients to continue training with little or no down time. Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery. Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons. Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options). Dr. Ricciardi believes in quality service and puts his patients first!
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