The first thing I was taught about treating children is that they are not just "little adults" as used to be the common idiom used in medicine. Kids have a different mindset, with a different set of coping skills. These also vary greatly depending on their age. It is important to remember this no matter what their foot problem may be.
Kids can have many different foot issues, ranging from ingrown toenails to painful flat feet. Almost every condition in the foot and ankle can be treated conservatively in children. When surgery is required, it is after trying everything else that is available. I believe this approach is helpful both for the patient as well as the parents.
There are many specific questions that can be best answered with a one on one discussion, but some of the most commonly asked questions are:
Are flat feet always bad?
Answer: not necessarily. There are many different types of flat feet and some don't cause any pain or problems. There are some types that are not painful with younger kids, but become painful as they get older. There are some genetic flat foot conditions that can cause long-term issues if not properly addressed.
These different types of flat foot are not always easy to tell apart. Pain is the best factor to help know that treatment is needed. Younger children will usually complain of "tired" feet or they won't want to walk and ask to be carried. Older kids (before teenage years) will often be able to point to a specific location which is usually the heel or arch areas.
Sometimes there is an obvious deformity of the foot (a larger bone than normal or the foot going in the wrong direction). Most often these things are due to a genetic condition and often need treatment at some point. If you notice these it is important to get it checked before your child complains of pain (which usually starts in teenage years).
If you are concerned about your child's flat feet, we would be happy to evaluate them and see if any intervention is necessary. Evaluation consists of an exam and xrays. Treatment for most flat foot conditions are conservative and surgery is rarely needed.
What can be done for my child's ingrown toenails?
Ingrown toenails are incredibly common in kids. They can become infected if not properly addressed and lead to a lot of pain. In teenagers, the first time you know about them is after they've been infected for 3 or 4 weeks. Not to worry though, they can still be well treated and excellent results are achievable.
If caught early, ingrown toenails can be permanently removed, preventing repeated infections. This procedure is done in the office under local anesthesia and kids as young as 7 typically do very well in this setting. On some occasions (for those younger than 7 or those who are very afraid of needles), this procedure can be done under sedation anesthesia successfully.
For more information click here: https://roberthadfield.com/ingrown-toenail/
My child has heel pain, what can be done?
There are two types of heel pain that occur in kids. One on the bottom and on on the back. Most often childhood heel pain is in the back and usually happens in kids age 10-14. This is called calcaneal apophysitis and is common when kids begin athletic activity after a period of rest (as in the fall when PE and sports start with school). This condition can be treated effectively without surgery in just a few weeks.
My child complains of foot pain but I can't tell exactly where, what should I do?
This usually happens in younger kids and it can be from a variety of foot conditions. As discussed above it can be from flat feet and a proper evaluation can she a lot of light on the cause.
My child's pediatrician said that they need orthotics, what are they and what do they do?
Orthotics are an insert that goes inside a shoe that helps correct many foot problems. There are two types: prefabricated and custom. Prefabricated (or off the shelf) orthotics come in a variety of quality levels, ranging from what you can get at the pharmacy to ones that are near custom level. Those bought at the pharmacy usually are gel based and most often do not provide the support needed to correct most foot problems.
Custom orthotics are made specifically for the patient after a mold is taken of the foot. This mold, combined with the specifications given by the doctor, is used to make an insert that is custom designed to correct the foot condition. They are very much like a pair of glasses made by an optometrist and give a custom level of correction that prefabricated orthtoics cannot. They are also much more durable than prefabricated insoles and can last many years.
At Hadfield Foot and Ankle we provide affordable prefabricated and custom orthotics for all types of foot conditions. Most often orthtoics are not covered by insurance and we understand the value of investing in your health. That doesn't mean that you have to break the bank, though.
We want to make sure you receive the highest level of care at an affordable price. If you have concerns about the cost of orthotics, or any other portion of your foot and ankle needs, we would be happy to work with you to make sure you're well taken care of. At Hadfield Foot and Ankle, you are a person first, not just a patient or a number.