Juniors

There are lower limb conditions that can affect children of different ages. Some are problems from birth where as others only become evident during puberty and early adolescence. These can affect either just one limb or both. Some of the more common ones are listed below with a brief description of their causes and some self treatment tips where applicable.

Sever’s Disease

This is a condition that presents as heel pain. It usually occurs at the start of puberty and the initial growth spurt that comes with it. Technically it is termed a ‘traction apophositis’ and refers to the growth plate on the back of the heel being pulled around and inflamed by aggravation from the tension put upon it by the achilles tendon.

It is made worse by tight calf muscles and with increased exercise. Children suffering from it tend to be quite active. Symptoms resolve/reduce within a day or so of the activity. Rest helps pain symptoms.

This condition is self limiting, which means that suffers will usually grow out of it. Once they stop growing and their skeleton stops growing then the problem resolves all on its own.

However, it can be painful and debilitating with sports participation for several years during the childs growing phases.

Curing this condition is difficult due to its cause being associated with the growing of the sufferer but there are many things that can be done to alleviate most if not all of the pain symptoms:

  • Calf Stretches
  • Good supportive and appropriate footwear with a slightly cushioned heel.
  • RICE after prolonged exercise and when the painful heel is at its worst.
  • Orthotics.

Should symptoms persist the opinion and further advice of a Podiatrist should be sought.

Curly Toes

Curly toes are one of the more common conditions seen in babies and young children where one of the lesser toes (i.e. not the big toe) curls under or over the next toe. It can occur on either or both feet. Causes of this deformity are largely unknown although muscle/tendon tightness is suspected in some cases and there is a strong family link. Treatment of this depends a great deal on the severity. Generally the condition causes very few long term problems and is often just monitored. The use of toe splints and/or manipulation (stretching) can be enough to improve its appearance. In some more severe cases surgery is required.

Lateral radiograph of the knee demonstrating fragmentation of the tibial tubercle (see inset) with overlying soft tissue swelling.Osgood-Schlatter Disease

This condition is almost identical to Severs except in its location. The knee is the painful part in this case. Usually on the front of the knee below the knee cap.

Sinding-Larsen-Johansson syndrome

As above but located on the knee cap itself, usually on the lower part.

Talipes-Equino-Varus – (Club Foot)

This condition is apparent from birth. there are still debates within the medical fraternity as to its cause, but its effects are quite obvious.

Treatment is usually a combination of many factors. Depending on the severity of the deformity sometimes the use of weekly plaster cast applications alone can be enough to rectify it. More commonly surgery is needed with/without the casting to improve the severity of the deformity.

Long term treatment of club foot usually relies on adapted footwear and the use of custom made functional orthotics.

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