Child's foot pain could be serious

Fitness Q & A

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My child has been complaining of ankle and foot pain. I talked briefly with a friend who is a physical therapist. Could it be his shoes?

It could be your child's shoes. But then, it could be something more serious.

Kevin Crowley, a physical therapist and manager of Towson Sports Medicine Center, says any time a child is complaining of reoccurring pain, you should consult your physician.

"As physical therapists," Crowley says, "we really can't diagnose patients. We help implement the treatment."

Dr. Teri Metcalf McCambridge, a sports medicine pediatrician at Orthopaedic Associates in Towson, says if your child has very old or very new shoes, that could cause some discomfort. But she says persistent pain could be liked to more serious conditions that affect the growth plates in the feet.

One example: Sever's disease. This condition is linked to an injury in the growth plate in the heel. McCambridge says she tends to see this injury in young children who play year-round sports that require cleats, such as soccer or lacrosse.

Doctors say that the foot is one of the first body parts to grow to full-size. Often, the bones outgrow the tendons or muscles, causing tightness. Treatment includes resting, stretching and wearing correct shoes.

"In this area, it's becoming a big problem," McCambridge says.

It doesn't help that children often wear flip-flops or clogs when they aren't running on athletic fields. These shoes offer little arch support for growing feet.

What's worse, says McCambridge, Crowley and other sports medicine experts, is that children are playing too many sports without any breaks, resulting in an increasing number of overuse injuries.

"It's gotten ridiculous," says Paul Welliver, sports medicine coordinator at Maryland SportsCare & Rehab in Westminster. "I've got varsity athletes who are playing soccer for their schools, then club games on Saturdays. And on Sundays, they're playing fall lacrosse. I've got my basketball players playing fall lacrosse and indoor field hockey. It's way too much.

"These kids are tired." he says. "They need a break."

Welliver, the father of two athletic daughters, has a rule: One team, one season. "We just won't buckle under the pressure."

In Baltimore, that pressure is intense.

McCambridge says parents would be prudent to follow recommendations by the American Academy of Pediatrics: Children should refrain from specializing in one sport until they are at least 14 years old.

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