Children's feet in Esperance
Children's feet and legs change a lot as they grow. Many things that worry parents, like flat feet, in-toeing or bow legs, are a normal part of development and sort themselves out with time. Others need a closer look.
This page explains what's usually normal, what isn't, and the common foot and leg problems we see in children and teenagers.
What's normal as children grow
Flat feet in toddlers and young children is common, due to fatty tissue and a systemic generalised ligamentous laxity:
Early Childhood (Ages 0–3): Toddlers have generalized ligamentous laxity (very stretchy, flexible connective tissues) and a natural fat pad under the foot. This is why almost all toddlers look like they have flat feet.
Mid-Childhood (Ages 4–10): This is the window where that laxity naturally decreases. The ligaments stiffen and shorten, the fat pad disappears, and the muscles strengthen. For about 80% of people, this "tightening" pulls the bones of the foot into a permanent structural arch.
Adulthood (Age 10+): For the remaining 20% of the population, that childhood tightening process simply didn't pull the foot bones into a high arch, or their baseline genetic makeup leaves them with more flexible ligaments. They transition into adulthood with flexible flat feet.
Flexible flat feet that don't hurt are very common and usually don't need treatment.
What else is considered normal
In-toeing (pigeon toes). Feet or knees that turn in when walking are common in toddlers and young children, and usually improve on their own by around 8 years of age.
Bow legs and knock knees. Bow legs are normal in toddlers, and many children then go through a knock-kneed stage between about 3 and 7. Legs usually straighten by around 7 to 8 years.
Tripping now and then. Young children are still developing balance and coordination, so the occasional trip is normal.
Signs worth checking
Book in with a podiatrist if your child has:
foot, heel, knee or leg pain
discomfort that’s limiting play or sport
a limp, or tires easily compared with other children their age
flat feet that are painful or stiff, or arches that look very different between the two feet
in-toeing, bow legs or knock knees that are getting worse, are much worse on one side, haven't improved by around 8 years, or you’re just curious about
frequent tripping or falling that seems more than other children their age
toe walking that continues beyond about 3 years of age
shoes that wear out unevenly or very quickly
Common problems in children and teenagers
Heel pain in active kids (Sever's, calcaneal apophysitis)
The most common cause of heel pain in children, usually between about 8 and 14 years of age. It's an irritation of the growth plate at the back of the heel, where the Achilles tendon pulls on it. It's common in active kids, especially during growth spurts and in sports with lots of running and jumping, such as football, netball, basketball and athletics. Pain is usually worse during and after sport, and kids may limp or walk on their toes.
Sever's (often called Sever’s disease - please note this is not a disease!) settles once the growth plate matures. In the meantime, treatment focuses on easing pain and keeping kids active:
calf stretching is the mainstay of treatment because the issue is the Achilles tendon, which is too tight, pulls excessively on the heel
adjusting training load, rather than stopping sport altogether
supportive footwear, avoiding bare feet and thin-soled shoes on hard surfaces
gel heel cups in sports shoes and school shoes to cushion and slightly lift the heel (we stock Tuli's Heavy Duty Gel Heel Cups)
orthotics, if foot posture is contributing, which is infrequently
Knee pain in teenagers (Osgood-Schlatter disease)
A similar growth plate irritation, just below the kneecap, causing a tender bump that's sore with running, jumping and kneeling. It's managed in a similar way: load management and stretching, this time of the quads. Read more on our ankle, leg and knee pain page.
Flat feet that hurt
Most flat feet in children are flexible and painless. If your child's flat feet are causing pain, tiredness or difficulty keeping up, or the feet are stiff, they should be assessed. Treatment may include footwear advice, exercises and, in some cases, orthotics. If you are worried about anything else on the foot that looks misshapen or unusual, it’s best to get that checked, just to be sure. Sometimes flat feet can be pain-free, but over years, bones and joints start to change shape in ways that are not reversible. Read more about flat feet.
Growing pains
An aching in both legs, usually in the calves or behind the knees, in the late afternoon or at night. It's common between about 3 and 12 years of age, the child will ask to have their legs rubbed, and they are well and pain-free the next morning. Gentle massage, stretching and warmth often help. If the pain is in a joint, on one side only, present during the day, or comes with a limp, swelling or fever, it's not typical growing pain and should be checked.
Skin and nail problems
Children get many of the same skin and nail problems as adults, particularly:
ingrown toenails, especially in teenagers
friction blisters from sport and new shoes
Choosing school and sports shoes
Good footwear is one of the simplest things you can do for growing feet:
Fit: there should be about a thumb's width between the longest toe and the end of the shoe, with enough width that the toes aren't squashed.
Fastening: laces, buckles or Velcro hold the shoe on the foot, so toes don't have to grip. Avoid slip-ons for everyday wear and sporting activities.
Heel counter: a firm back to the shoe that holds the heel steady.
Flexibility: the shoe should bend where the foot bends (at the ball of the foot), not in the middle.
Check the size often: young children's feet can grow a size every few months. Avoid handing down well-worn shoes, which have already moulded to someone else's foot.
Book an appointment
If you're worried about your child's feet, legs or the way they walk, book in with Rebecca at Esperance Podiatry. No referral is needed. Please bring the shoes your child wears most often, including sports shoes.
Call (08) 9072 1514 or visit us at Suite B, 116 Dempster Street, Esperance.