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pediatric care

Flat feet

Growing pains

  • Severs

    • Sever's disease is a pediatric condition that consists of swelling and irritation of the growth plate in the heel. The growth plate consist of cartilage and is located in the back of the heel bone in regards to the calcaneus. The growth plate is typically weaker and more at risk for injury than the rest of the bone.

    • Sever's disease symptoms

      • swelling and redness in the back of the heel

      • stiffness in the feet in the morning

      • limping and toe walking

      • pain when the heel when squeezed

    • Symptoms are usually worse during activity and improve with rest.

    • Sever's disease can only occur during the growth spurt of puberty. During a growth spurt, the bones, muscles, and tendons grow at different rates. The muscles and tendons pull excessive force on the growth plate in the heel as a result of the long bones of the legs growing too quickly. This injury leads to the pain of Sever's disease.

    • Sever's disease typically happens in kids who are:

      • in their growth spurt

      • activity in sports or activities that involve a lot of running or jumping, especially on hard surfaces

    • Treatment includes NSAIDS and limitation in physical activity for a few weeks.

Ingrown nails

  • Very common pediatric condition typically caused by improper management of toe nail trimming.

  • See ingrown nail page


In-toeing is referred to as a tendency for feet to turn inward or “pigeon-toed”, while out-toeing is the tendency for feet to point outward.


  • Tibial torsion

  • metatarsus adductus

  • femoral anteversion

In-toe and out-toe can sometimes be addressed with bracing or orthotics with a gait plate at a young age.

Toe walking

Toe walking is a condition when children walk on the balls/forefoot of their feet. Toe walking is a fairly common in many children in early stages of walking. Typically children outgrow this condition.

If toe walking continues after toddler years, it should be addressed. Toe walking sometimes can result from certain conditions, including cerebral palsy, muscular dystrophy and autism spectrum disorder. Other conditions that are occur with normal development include tight leg muscles, stiffness in the Achilles tendon or a lack of muscle coordination.

In a few cases, toe walking is caused by an underlying condition, such as:

  • A short Achilles tendon. 

  • Cerebral palsy. 

  • Muscular dystrophy. 

  • Autism. 

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