Aug2012_Podiatry Perspective: The Limping Child
Foot pain in adults is a common occurrence and is easily identified. An adult can easily distinguish pain as an unpleasant and abnormal sensation, describe it to someone else and actively seek help.
But what if the person experiencing foot pain doesn’t even know what pain is, cannot communicate effectively or just sees it as normal part of life? This is challenge of diagnosing painful lower limb conditions in children for both practitioners and parents alike.
The most important thing for parents to know is that pain in anybody is not normal, especially in children, and should not be tolerated.
An uninjured, limping child is an alarming and confusing sight. There are many possible causes of limping in children but the focus of this article is on conditions called Osteochondroses which affect the growth plates of bones. Osteohondroses present in different bones at different ages. The following is a brief and rough guide of the most common types and presentations.
1. Kohler’s Disease – Limping Toddler
This is a relatively rare condition which affects the mid-foot in children between the ages 2 and 5. More commonly affects boys and presents with a pronounced limp and possibly a flat foot. This condition will cease on its own but needs treatment to reduce pain.
2. Perthe’s Disease – Young Child with Chronically Painful Hip
Difficult at first to diagnose as it can present as intermittent pain in the knee or groin. This condition affects the top of the thigh bone in boys aged between 4 and 11 and can cause significant differences in leg length. Diagnosis by X-Ray or MRI may be required. Early detection and treatment can help reduce the chance of large leg length issues.
3. Freiberg’s Infraction – Painful Forefoot in Athletic Girls
A very painful condition which affects the bones in the forefoot. It is more common in girls from the age of 8 to late teens. This condition will typically affect active girls (e.g dancers, sprinters or jumpers) and often results in forefoot osteoarthritis in later life. Immediate treatment is required.
4. Sever’s Disease – Painful Heel in Active Boys: Young Football and Soccer Players
Very common and usually affects active boys between the ages of 7 and 15. It presents as painful heels and is caused by traction from Achilles tendon, faulty foot biomechanics and repetitive microtrauma. Rest, stretching and correction of foot biomechanics is required.
5. Osgood-Schlatter Disease – Painful Knees in Active Teenagers
One of the most common causes of knee pain in adolescents which affects the front of the shin bone just below the knee. It is most common in active boys between the age of 13-17. It is caused by rapid growth of the thigh bone and poor foot biomechanics. It is treated by rest, stretching and correction of foot mechanics.
The most important thing for parents to know is that pain in anybody is not normal, especially in children, and should not be tolerated.
An uninjured, limping child is an alarming and confusing sight. There are many possible causes of limping in children but the focus of this article is on conditions called Osteochondroses which affect the growth plates of bones. Osteohondroses present in different bones at different ages. The following is a brief and rough guide of the most common types and presentations.
1. Kohler’s Disease – Limping Toddler
This is a relatively rare condition which affects the mid-foot in children between the ages 2 and 5. More commonly affects boys and presents with a pronounced limp and possibly a flat foot. This condition will cease on its own but needs treatment to reduce pain.
2. Perthe’s Disease – Young Child with Chronically Painful Hip
Difficult at first to diagnose as it can present as intermittent pain in the knee or groin. This condition affects the top of the thigh bone in boys aged between 4 and 11 and can cause significant differences in leg length. Diagnosis by X-Ray or MRI may be required. Early detection and treatment can help reduce the chance of large leg length issues.
3. Freiberg’s Infraction – Painful Forefoot in Athletic Girls
A very painful condition which affects the bones in the forefoot. It is more common in girls from the age of 8 to late teens. This condition will typically affect active girls (e.g dancers, sprinters or jumpers) and often results in forefoot osteoarthritis in later life. Immediate treatment is required.
4. Sever’s Disease – Painful Heel in Active Boys: Young Football and Soccer Players
Very common and usually affects active boys between the ages of 7 and 15. It presents as painful heels and is caused by traction from Achilles tendon, faulty foot biomechanics and repetitive microtrauma. Rest, stretching and correction of foot biomechanics is required.
5. Osgood-Schlatter Disease – Painful Knees in Active Teenagers
One of the most common causes of knee pain in adolescents which affects the front of the shin bone just below the knee. It is most common in active boys between the age of 13-17. It is caused by rapid growth of the thigh bone and poor foot biomechanics. It is treated by rest, stretching and correction of foot mechanics.
Although all the above conditions will improve with age, it is important to seek a specialist assessment and treatment in order to reduce the levels of pain experienced by the child. I believe that no child should endure pain if it can be prevented. To book, please ring Sergio Gonzalez Podiatry on 3425 1777.
