Podiatry and teenagers

Teens still have a growing foot and, while many of the foot problems they experience are sporting related, many are also related to the shoes they commonly wear, and can often be easily fixed.

Sport Injuries

High-impact sports such as basketball, soccer, running, football, cricket, and indeed any sport involving increased force and pressure on the feet, can impact the feet and lower limbs, especially where there are open growth plates. Sports injuries come in two forms: overuse injuries caused by repeated pressure on tendons and joints; and biomechanical injuries caused by incorrect movement patterns. Biomechanical injuries are often impacted by overuse problems, as athletes may be changing the way they walk, run or jump to compensate for an existing injury, thereby causing further damage. The most prevalent sports injuries in teenagers include shin splints, Osgood Schlatter disease, Calcaneal Apophysitis, and apophysitis at the base of the fifth metatarsal (Iselin’s disease).

The two common foot and leg problems related to sports are:

* Osgood-Schlatter disease: Osgood-Schlatter disease is a painful knee condition that often develops between 10-14 years. It may occur during periods of rapid growth and is worse when playing sport. Symptoms may occur in one or both knees with localised pain and swelling at the tibial tuberocity. The condition usually completely resolves. Treatment often involves activities modification, pain relief, icing and strengthening exercises. In some cases, orthotics have been shown to assist in pain relief.

* Calcaneal Apophysitis , also known Sever’s disease, can affect either one or both heels. It is common in adolescents between the ages of 8-14 years. It is caused by inflammation and micro trauma at the calcaneal apophysis. It is thought that inflammation and micro trauma occurs as a result of tractional forces from the achilles tendon on the apophysis, or/and impact forces on the calcaneus during walking and sporting activities. Treatments such as icing, activity modification, and in-shoe devices such as heel raises and off-the-shelf orthoses have also been shown to assist pain relief and maintain activity levels.

Footwear

The teenage foot is still growing, and overuse or impact injuries are common when wearing shoes with minimal support. Fashion shoes may cause minor injuries including blisters and calluses, and have the potential to cause pain in the arch and heel. Teens should be encouraged to avoid shoes with very flat soles such as Vans, Volleys and ballet flats that may cause foot and lower limb pain through insufficient support.

Growing pains

Teen experiencing growing pains will have no joint pain and will otherwise seem perfectly healthy. Growing pains will resolve in time. Once the bones of the feet and legs are fully developed all symptoms of growing pains will fade.

Skin and nail conditions

Hormonal changes in growing teens combined with fashion footwear can also lead to increased foot odour, ingrown toenails and tinea. Not changing shoes or socks or washing feet regularly can lead to an increase in the bacteria that feeds on sweat; this is what causes the foot odour. Good hygiene and even the use of foot deodorant can help. Increased sweaty conditions can also lead to nails growing into the skin easily and a podiatrist can assist with short and long-term management of these.

This resource has been provided by an Australian Podiatry Association (APodA) member podiatrist as part of Foot Health Month 2014

Teens and podiatry

From flat-soled sneakers to strappy stilettos, teens make choices about footwear that may affect their feet. The teenage foot is still growing; bones and soft tissue may be affected by shoe choices. There are also a number of growth plates in the foot bones that are still open. Shoe choices with limited cushioning can cause pain in these areas. Fashion shoes generally have limited support, and have the potential cause injuries such as sprains, strains or ingrown toenails. Fitting the shoe to the activity is the best way to avoid potential problems but this can be a challenge when fashion is often prioritised over comfort.

Flat-soled canvas-type sneakers have limited cushioning between the ground and our feet. While these are great for skateboarding or for kicking back with friends, they aren’t built for walking long distances. These shoes also give little support while walking on concrete or tiled floors, especially in shopping centres or out with friends, and can sometimes result in pain under the heels on in the arch area.

Additionally, shoes with elasticated sides give little support, so encourage teens to opt for shoes with laces to give a better fit, together with a more padded and shock-absorbing sole for cushioning. Try to encourage more structured footwear while out and about and, if foot pain continues with a more substantial sneaker, then a podiatrist can assist and provide footwear advice or determine if anything else is required inside the support to provide pain relief.

Ballet flats are another popular shoe that, when worn for substantial periods of time, may cause some pain and discomfort. The soles of ballet flats are often so thin that the ground can be felt through them, leaving virtually no protection between feet and the concrete. Add to that the lack of any straps or laces and the feet are in for a hard time. Wearers of ballet flats often have the same heel and arch problems as wearers of flat-soled sneakers. Additionally, the lack of any straps or laces means that the wearer has to scrunch up their toes to grip the shoes as the only means of keeping them on. This constant toe scrunching can lead to corns, calluses and, in the longer term, there is the potential for the toe shape to change, possibly causing future shoe-fitting difficulties.



High heels are another challenge for teenage girls. Towering heels may look fabulous, but they have the potential to cause pain in the ball of the foot, arch pain, calluses and corns, particularly in growing feet with bones that are not fully developed. Fashion shoes are here to stay, but there are always options when purchasing fashion shoes so making good choices is important. Even when teens do have some shoes that have limited support, encourage limiting the duration of wearing time and ask teens to consider what they will be doing while they are wearing them.