LOWER LIMB AND FOOT PROBLEMS IN CHILDREN
By: Sara John, C.Ped (C)., C.Ped Tech (C)
Children can suffer from knee and heel pain just like adults and can be affected by poor biomechanics.
Knee Pain – Osgood-Schlatter’s Disease
Osgood-Schlatter’s disease is a common cause of knee pain in growing children especially boys between the ages of 10 and 15, but it can occur in younger children too. It is an overuse injury that affects the insertion of the patellar tendon just below the knee where it attaches to the shin bone at the tibial tuberosity.
Osgood-Schlatter disease most often occurs during growth spurts, when bones, muscles, tendons, and other structures are changing rapidly. When a child is active, the quadriceps muscles pull on the patellar tendon which in turn, pulls on the tibial tubercle. This recurrent pulling tension of the patellar tendon by the large muscles in the front of the thigh can lead to inflammation of the growth plate. The prominence of the tibial tubercle may become very pronounced causing pain, swelling and tenderness just below the knee joint.
Patellar brace aids in improving patellar tracking. Off the shelf or custom made orthotics help in ensuring the foot is in optimal alignment and not causing undue rotation of the lower leg or stressing the tibial tuberosity.
Heel Pain – Sever’s Disease (Calcaneal Apophysitis)
Sever’s Disease is the equivalent of Osgood Schlatter’s disease usually occurring between the ages of 10 and 15, more common in boys than girls. It is an inflammation of the growth plate in the heel of active growing children and is characterized by pain, swelling and tenderness at the back of the heel and limits mobility.
Sever’s Disease is caused by repetitive stress to the heel and disturbance to the growth plate at the back of the heel where the strong Achilles tendon attaches. The condition presents as localized pain in the back and plantar side of the heel aggravated by physical activity. Sometimes, the pain may be so severe that it may cause limping and interfere with physical performance in sports.
Along with adequate rest and other modalities of treatment, proper footwear is important to assist in recovery. Orthotics and heel lifts aid in lessening the strain in the back of the heel.
