Watch for These Common Foot Problems in Children


Children are affected by many of the same foot problems adults experience, including flat feet, plantar warts, ingrown toenails and heel pain. Some conditions occur more commonly in kids and are affected by their active lifestyles.

“I sometimes see toddlers because parents are concerned about the way their children are walking,” says Dr. Mark Smesko. “The majority of children are flat footed and toe walkers. I do exams, watch them walk and most times there are no issues. Some may need orthotics in their shoes to realign their feet. On a rare occasion, there may be a problem with a child’s knee or hip that may need to be referred to a pediatric orthopedic specialist.”

The following conditions are common in children.

Plantar Warts

Plantar warts can occur at any age but are very common in children. Caused by a virus, some warts respond to topical acid treatment but most need a laser procedure to eradicate the problem.

“I perform a laser procedure on most warts,” Dr. Smesko said. “This is great for kids because no anesthesia is required. So there is no shot, no wound and, most times, the child can resume activities on the same day.”

Ingrown Toenails

An ingrown toenail occurs when the edge of the nail, usually on the big toe, grows into the skin. This results in pain with activity and shoe gear and can lead to infection.

Often times this problem is hereditary in nature.

“I see quite a few kids with ingrown nails,” says Dr. Smesko. “If there is an infection present, an oral antibiotic is prescribed prior to any procedure. Once the infection is calmed down, I most commonly perform an in-office procedure under local anesthetic to remove the offending nail border.

“Then I use a chemical to kill the root of the nail so that portion of nail does not grow again. Less than 10 percent of the time does that side of the nail grow back after this surgery. Most times, the child can return to all activities after a few days.”

Heel Pain

Heel pain is another ailment that affects kids, most times between the ages of 8 and 14. With kids becoming more active year round in athletic activities, heel pain is becoming more common.

“I commonly see kids who go from one sport to the next, 12 months out of the year,” Smesko states. “Most heel pain is due to Sever’s disease, which is also called Calcaneal Apophysitis.

“As kids get bigger and more active, they put more stress and strain on their bodies. It is common for the growth plate of the heel to become sore and inflamed.”

The growth plate in the back of the heel attaches to the Achilles tendon as well as to the plantar fascial ligament. Tight calf muscles and overuse result in pain.

“The treatment for this consists of activity modifications, stretching exercises and support for the foot,” says Dr. Smesko. “Orthotics are commonly used as well as physical therapy in some instances. In severe cases, the child may need to stop playing sports and other activities for several weeks to calm down the pain.”

While most kids are active and healthy, certain foot issues will not get better on their own. If your child has any of these problems, please contact one of our offices to make an appointment.


Orthotics: A Non-Surgical Solution for Heel Pain

Among the most effective treatments for heel pain is the use of custom-made orthotics, which are foot supports worn in shoes and designed to alleviate pain by supporting natural foot movement.

Orthotic technician Tina Adkins helps set patients up with custom orthotics that can alleviate heel pain.

Many individuals suffer from pain in the heel, knee and lower back and may not realize their pain can be caused by poor foot function. Orthotics provide a non-surgical way to realign the foot and ankle bones to their neutral positions and decrease abnormal motion and pressure.

Tina Adkins, an orthotic technician, has been working with orthotics in Ankle and Foot Care’s diagnostic center in Boardman for over 13 years. She and her colleagues work closely with physicians in a regular process for fitting patients with custom-made orthotics.

A physician will decide if an orthotic device is necessary for a patient.  After Tina receives the patient’s prescription, she starts the fitting process, which is a 45-minute evaluation with the patient.

First, the patient walks in front of her so she can see if there is any noticeable abnormal movement of the feet, such as rolling inward or outward.  (Sometimes the scan doesn’t pick up what the eye can see, she explains.)

Next, the patient walks on a mat that performs a scan of the feet and creates a graph on Tina’s laptop.  The graph shows pressure points in certain parts of the foot, as well as other abnormalities. Tina can then design the fit for the custom orthotics right from her computer.

The orthotics arrive within a couple of weeks and the patient goes in for a final fitting with a physician or licensed orthotist.  He/she leaves the appointment with the foot scan and the custom-designed orthotic device.  If patients do not feel 50 percent better within 3-4 weeks, they are told to come back into the lab so technicians can readjust the orthotics.

Patients can choose among many different kinds of orthotics designed specifically for athletic shoes, work boots, dress shoes or everyday shoes.  One of the newest designs, referred to as the “cobra,” is shaped like a snake with the heel cut out, so that it can fit into a high heel shoe.

Orthotics can also come with heat-resistant material that decreases sweating or silver that decreases smell.

foot scan

This patient had heel pain in her right foot and was rolling on the outside of the foot to compensate, the foot scan shows.

“We have orthotics for everyone,” Tina says, as she explains the difference between orthotics for soccer, football, golf and even hockey.  “There are even orthotics that are waterproof.”

Tina sees about eight patients a day, all with different kinds of pain, but plantar fasciitis and heel pain tend to be the most common.

If you have serious pain or discomfort, schedule an appointment with a foot and ankle physician. He or she will examine your feet and ankles and suggest activity or treatment to improve comfort and function, including custom-made orthotics if appropriate.

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Dr. Ramy Fahim of Ankle & Foot Care Centers in Warren, Ohio, talks about treatment for posterior heel pain. Dr. Fahim is a fellowship-trained podiatric foot and ankle surgeon.

Remedies for Fungal Toe Nails with Dr. Fahim

Dr. Ramy Fahim of Ankle & Foot Care Centers in Warren, Ohio, talks about treatment for fungal toe nails. Dr. Fahim is a fellowship-trained podiatric foot and ankle surgeon.

Treatment Options for Hammertoes with Dr. DiDomenico

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Dr. DiDomenico Addresses Treatment for Bunions

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