KIDS FEET

Are Growing Pains Normal in Kids Feet?

About a third of children experience “growing pains.” The cramping type pain, often in the calf muscle or behind the knee is felt at the end of the day or wakes the child through the night. Gentle massage gives some relief, but is often not entirely successful in kids feet. The most common age for this to occur is around 3-5 years, but the episodes can last up to adolescence. There doesn’t seem to be any real link between the growth of the child and the occurrence of pain, it is more likely to be associated with muscle fatigue, over-exertion and associated with flat footedness and knock knees. If a child is experiencing leg aches it is wise to seek the advice of a podiatrist. Leg aches can often be treated with simple shoe insoles made by the podiatrist.

Heel pain in active teens and pre-teens

Active children between the ages of 9 and 14 are prone to a condition called ‘Sever’s Disease’. The heel bone is made up of many growth centers at the back of the heel, it is in this area that pain occurs with activity in kids feet, and can be severe enough to cause a limp. Reducing the level of activity, stretching of a tight Achilles tendon, cushioning and footwear advice are the first step to recovery.

If these simple treatments don’t ease the pain, a longer-term treatment plan addressing faulty foot mechanics or foot alignment, with orthoses usually resolves the symptoms. A podiatrist is trained to assess the cause of ‘Sever’s Disease’ and prescribe appropriate short and long-term treatment to resolve the heel pain. Stages of growth and development As the lower limb grows and develops there are noticeable changes to the appearance of the legs and feet. The foot starts off as very soft cartilage and bone takes most of the developing years through to late teens to fully ossify. The foot not only lengthens with growth but the heel also widens to the adult size. The posture of most legs by age 7-8 is straight, but these legs have already been through phases of being ‘bow legged’ and ‘knock kneed.’ Your podiatrist is trained to recognize the normal stages of development and diagnose potential problems.

Common childhood conditions in treated by podiatrists

Pigeon (in-toeing) or out-toeing gait, assessment of flat feet or high arched feet, unusually shaped feet from birth (club feet) or other shapes that look out of the ordinary. Some medical conditions such as cerebral palsy particularly affect the lower limbs and can be assisted by podiatric care.

BIOMECHANICS

FORCE PLATE ASSESSMENT

What are Force Plate Assessments?

Postural control organises the orientation and equilibrium of the body during upright stance and is essential to the successful performance of daily movements and activities as well as fall prevention. Force platforms or force plates are measuring instruments that measure the ground reaction forces generated by a body standing on or moving across them, to quantify balance, gait and other specifications of bio mechanics, these assessments are called Force Plate Assessments. Most common areas of application are medicine and sports. Force plates are used for postural control assessments, clinicians are using this technology to assess patients.

A highly sensitive mat records pressure distribution and foot motion whilst your foot is in contact with the ground. The results will indicate what foot type you have, (low, medium, or high-arch, supination and pronation, etc). How this information is interpreted sets us apart from the rest. Understanding how your foot performs dynamically will ensure the best fitting shoe and custom insole perform specifically for your sport.

The analysis can highlight bio mechanical deficiencies that often result in injury, the combination of correct footwear and custom insole can reduce the chance of these injuries.

Finally, you are recorded running on the treadmill with your new custom fitted shoes. This is played back along-side your original footwear to ensure they are functioning perfectly and to demonstrate the difference.

VIDEO GAIT ANALYSIS

Video Gait analysis has been progressively used to assess a person’s movement sequence keeping in mind the end goal to help with diagnosing pathologies, enhancing sports execution as well as checking therapeutic interventions, for example, gait retraining or footwear changes. The instruments fused into Dartfish high speed video analysis programming enables observers to playback in slow motion, amplify, and control the video image in order to do such things as calculate joint angles and get various measurements. A current review demonstrated that the unwavering quality of gait parameter information was higher with Dartfish software than with standard video programming that did not have these apparatuses.

A professional level gait analysis includes considerably more than viewing a video of gait. A point by point clinical exam would likewise incorporate muscle strength and balance testing, static and dynamic scope of-movement measurements, footwear assessment, detailed injury and medical history and an audit of the athlete’s training program. This would, as a rule, be done preceding the video gait analysis.

THE GAIT CYCLE

The gait cycle begins when the foot contacts the ground and finishes when a similar foot contacts the ground on the following stride. The two noteworthy components of the gait cycle are the position stage and the swing stage. These cycles might be further broken down into key focuses, for example, starting contact, mid-stance, toe-off for each side. The stance phase of gait refers to the point in the gait cycle where the foot is in contact with the ground. In typical walking, stance starts at the heel and moves to the toe and keeps going around one second. A walker lands with 1-1.5 x bodyweight.

The swing phase of gait happens after the foot leaves the ground until the next foot contact occurs. The leg is swinging forward and preparing for the next foot strike. Variations from the norm or asymmetries in swing stage may show an issue during contact that is being made up for while the leg is in the air. Walking versus Running: In walking gait there are periods when both feet are in contact with the ground all the same time and at least one foot is dependably in contact with the ground at any given time. In running gait just a single foot contacts the ground at a time and there are periods where neither one of the foot is in contact with the ground. Running gait is more variable. 80% of runners land on their heel when in shoes, and the remaining 20% of runners land either on their mid or forefoot. The foot is in contact with the ground for one tenth to five tenths of a moment while the runner is landing with 2.4-3.0 times their bodyweight. Overuse injuries to the lower furthest point are regularly brought about during the stance phase of gait. Barefoot running versus running in shoes: It has been well documented that people move differently when unshod, so contrasting unshod running gait to gait in shoes resembles contrasting one type with a totally different type. Walking barefoot gives a benchmark assessment of a subject’s weight bearing useful movement pattern and is an essential part of any analysis. Anyone will quickly observe that it is considerably more difficult to confidently access the alignment of the foot once it is covered by a shoe – even with high speed and stop-motion video.

At Alexander and Farrell Podiatry, we offer a video gait analysis.