Clubfoot is a deformity in which an infant's foot is turned inward, often so severely that the bottom of the foot faces sideways or even upward. Approximately one infant in every 1,000 live births will have clubfoot, making it one of the more common congenital foot deformities. Clubfoot is not painful during infancy. However, if your child's clubfoot is not treated, the foot will remain deformed, and he or she will not be able to walk normally. Most cases of clubfoot are successfully treated with nonsurgical methods that may include a combination of stretching, casting, and bracing. Treatment usually begins shortly after birth.
Flexible flatfoot is common in children. While parents often worry that an abnormally low or absent arch in a child's foot will lead to permanent deformity or disability, most children eventually outgrow flexible flatfoot without developing any problems in adulthood. The condition is usually painless and does not interfere with walking or participation in sports. If your child’s flexible flatfoot does not cause pain or discomfort, no treatment is needed. In a small number of children, flexible flatfeet become rigid instead of correcting with growth. These cases may need further medical evaluation.
Intoeing means that when a child walks or runs, the feet turn inward instead of pointing straight ahead. It is commonly referred to as being "pigeon-toed." In the vast majority of children younger than 8 years old, intoeing will almost always correct itself without the use of casts, braces, surgery, or any special treatment. Intoeing by itself does not cause pain nor does it lead to arthritis. A child whose intoeing is associated with pain, swelling, or a limp should be evaluated by an orthopedic surgeon.
A tarsal coalition is an abnormal connection of two or more bones in the foot. The bones affected — called tarsal bones — are located toward the back of the foot and in the heel, and the connection of the bones can result in a severe, rigid flatfoot. Although tarsal coalition is often present at birth, children typically do not show signs of the disorder until early adolescence. The foot may become stiff and painful, and everyday physical activities are often difficult. For many children with tarsal coalition, symptoms are relieved with simple treatments such as orthotics and physical therapy. If a child has severe symptoms that do not respond to simple treatments and continue to interfere with their daily activities, surgery may be recommended.
Sever’s disease is one of the most common causes of heel pain in growing children and adolescents. It is an inflammation of the growth plate in the heel. It is caused by repetitive stress to the heel and most often occurs during growth spurts. In most cases of Sever’s disease, simple measures like rest, over-the-counter medication, a change in footwear, and stretching and strengthening exercises will relieve pain and allow a return to daily activities.
Toe walking is a pattern of walking in which a child walks on balls of his or her feet with no contact between the heels and ground. Toe walking is common in children who are learning to walk. Older children who continue to toe walk may do so simply out of habit or because the muscles and tendons in their calves have become tighter over time. Treatment for persistent toe walking often involves a period of casting or bracing to help stretch the muscles and tendons in the calves and encourage a normal gait.
Vertical talus is a rare deformity of the foot which is diagnosed at the time of birth. The talus bone has formed in the wrong position and other foot bones have shifted on top of it resulting in the front of the foot pointing up and the bottom of the being stiff with no arch (it usually curves out). Although it is not painful for the newborn or even the toddler, if it is left untreated, vertical talus can lead to serious disability. Surgery is typically recommend at 9 to 12 months of age.