Robert Rosenstein, DPM
Michael Coppers, DPM
CONDITIONS AND TREATMENTS
CHILDREN'S FEET
Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.
Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.
Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). "Extracorporeal" means "outside of the body." During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.
Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time -- six months or more -- and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or "twilight" anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.
People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).
This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 70 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.
Children with strong, healthy feet avoid many kinds of lower extremity problems later in life. That's why it is important to inspect your children's feet periodically.
Infants
The size and shape of your baby's feet change quickly during their first year. Because a baby's feet are flexible, too much pressure or strain can affect the shape of their feet. It's important to allow baby to kick and stretch their feet freely. Also, make sure shoes and socks do not squeeze the toes.
Toddlers
Do not to force a toddler to walk before s/he is ready. Once walking begins, watch the toddler's gait. Many toddlers have a pigeon-toe gait, which is normal. Some initially learn to walk landing on their toes instead of their heels. Most children outgrow both these problems. But other conditions detected early can be treated more easily.
When Foot Care Is Needed
To help with flatfeet, special shoes or orthotics may be prescribed. To correct mild in-toeing or out-toeing, your toddler may need to sit in a different position while playing or watching TV. If your child's feet turn in or out a lot, corrective shoes, splints, or night braces may be prescribed.
The foot's bone structure is well-formed by the time your child reaches age 7 or 8, but if a growth plate (the area where bone growth begins) is injured, the damaged plate may cause the bone to grow oddly. With a doctor's care, however, the risk of future bone problems is reduced.
Remember to check your child's shoe size often. Make sure there is space between the toes and the end of the shoe and that the shoes are roomy enough to allow the toes to move freely. Don't let your child wear hand-me-down shoes.



