Six Foot Problems In Infants And Children: Podiatrist Review

When it comes to children, knowing what foot pain or problem is normal, what will get better on its own, and what is a cause for concern that requires podiatrist treatment can be really hard. After all, children’s feet and legs change so much over the years as they grow stronger and bigger, and ultimately reach maturity. To help, here’s our guide on six common foot problems in infants and children that we see, what could be causing them, and what you can do about it.

1. Curly Toes

Medically known as clinodactyly, curly toes describe a toe position where the toes noticeably curl downwards when your child is standing or walking, sometimes even curling inwards beneath the adjacent toe. This happens because the tendons that run beneath the toes are tight, so pull the toes downwards to create a curl. While the cause of the tendon tightness isn’t very clear in the research, it does tend to run in families. It is usually the third, fourth and fifth toes that tend to curl, and some toe curling can be noticeable from birth, though many parents really notice it around the time their child starts to walk.

The good news is aside from their appearance, in most cases, curly toes do not cause any pain or functional impairments. When symptoms do arise, it is the repeated pressure on the curly toes from running, walking and wearing shoes that can lead to problems with the nails and skin such as nail thickening, changes to the shape and appearance of the nail, corns, calluses, blisters and more.

If you notice curly toes in the very early years, we tend to go by the rule of “it’s not a problem unless it’s a problem”. This means that if you’ve noticed your child’s toes curling but there’s no redness and it’s not causing them any pain or discomfort, then you are safe to leave them - especially if the toes are still flexible and healthy otherwise. You can also give the toes a gentle massage as part of your bedtime routine to help gently stretch the tight tendons beneath the toes. Most curly toes that we see in childhood resolve without any issues to the child as they grow.

2. In-toeing

Also known as having pigeon toes, in-toeing is a common children's foot problem where the toes point inward instead of straight ahead when walking or running. This is most commonly observed within the first years of walking. There are several potential causes of in-toeing, which include:

• Metatarsus adductus: this describes a banana-shaped curve in the foot that is present at birth, most likely from the position of the feet in the womb. This should be seen promptly for management (shortly after birth), and will typically resolve by the age of two.
• Tibial torsion: this in-toeing is caused by the inwards (internal) rotation of the shin bone (tibia). It typically resolves by five years old, but if in-toeing persists beyond the age of five or causes problems in the interim like tripping, falling or clumsy walking, it’s important to see your podiatrist.
• Femoral anteversion: this cause of in-toeing describes the thigh bone (femur) rotating inwards, which in turn rotates the kneecap and the lower legs, including the feet. This becomes particularly noticeable when your child is running around. This cause of in-toeing tends to persist the longest, typically resolving by age 11 or so. Like tibial torsion, if the in-toeing is causing pain, tripping, balance issues or other problems, see your podiatrist.

3. Ingrown Toenails

Ingrown toenails occur when the edge of a toenail grows into the surrounding skin, leading to pain, redness, and swelling. And it can be very common in kids, even as early as a few months old. Ingrown nails are often caused by improper nail trimming where a sharp area of nail is still left in the corners (often below the adjacent skin where it is difficult to see), wearing tight-fitting shoes (which is common given how quickly kids outgrow shoe sizes), or injury to the toe. 

If your child has an ingrown toenail, you may notice one or both sides of their toenails appearing red and swollen, and the area being tender to touch. If the ingrown toenail becomes infected then there may be some discharge coming from the nail, too. Ingrown toenails can be treated safely and effectively by your podiatrist, typically without the need for antibiotics. While warm water soaks and wearing comfortable shoes with a roomy toe box can help keep the symptoms at bay at home, your podiatrist will remove the sharp nail spicule that has grown into the skin. This is done very quickly, and depending on the age of the child and their suitability for it, we may be able to use some anaesthetic to help with any pain concerns.

4. Knock Knees

Medically known as genu valgum, knock knees describes a leg and knee position where the knees are facing more in towards one another and can touch or rub against one another when walking, but the ankles do not touch. You may notice an awkward gait or a tendency for the child's knees to knock together. Knock knees are actually a normal alignment variation in the early years, particularly around 3 years of age. This should resolve by seven years old. If knock knees persist beyond the age of 7, or if they’re causing pain or problems like causing your child to trip when running, bring them in to see a podiatrist.

5. Toe Walking

In toe walking, a child consistently walks on the balls of their feet without their heels touching the ground. This is fairly common in toddlers that are learning to walk and therefore explore all of the different ‘fun’ ways of walking, but typically resolves as they develop a heel-to-toe walking pattern. Persistent toe walking beyond the age of 2-3 years may be associated with problems like tight calf muscles or sensory processing disorders. If your child is still toe walking beyond the age of three and seems unable or unwilling to support their heel in making contact with the ground, it’s a good indication to bring them in to be seen by a podiatrist.

6. Growing Pains

Growing pains are a common but poorly understood condition characterised by recurrent episodes of foot or leg pain in children often between the ages of 6-16 years. These pains are typically experienced in the muscles, rather than the joints. Children with growing pains may complain of aching or throbbing discomfort in the legs, often during or after exercise, and sometimes at night. 

Growing pains occur when growth plates (the vulnerable areas to which new bone is added so that our bones grow and lengthen) become irritated or inflamed. We often see this pain at the back of the heel, the outside of the foot, or at the knees. While growing pains can resolve on their own, you also don’t need to wait months or years for your child’s pain to resolve and there are various treatment approaches podiatrists can implement to help.

If you want your child’s feet checked and assessed for any problems, our podiatrists are here to help. There’s no minimum age to bring your child in to see a podiatrist, and we see problems like ingrown toenails as early as 6 months old, and most other conditions from the time children start walking. We love working with children and helping them stay happy, healthy and active on their feet.