Children's Feet

Your child’s feet are very important in most of their day to day actions and any problems are best detected early to prevent more serious foot, leg or back complications later in life. Children’s feet develop rapidly with almost half of the growth done in the first year of their life. By around 18 months of age, a child’s foot is about 90% of its adult length. There are a surprising number of common foot problems in children’s developing feet and legs. If you have any concerns about your child’s foot health, seek the advice of a podiatrist.

Tips for Foot Development


At six months of age the foot is still predominately soft cartilage, so you need to ensure that there is not pressure on the developing foot. To encourage normal development of muscles in the legs and the feet, baby’s feet are best left unconstrained so they can kick feely. Let your baby be barefoot as much as possible and avoid tight socks or tight grow suits.

Toddlers starting to walk:

Children will generally begin standing and walking around 12-18 months of age. Let them be barefoot or just wearing socks where possible as this will help improve sensation and promote normal foot growth. It is advisable to have any shoes fitted by an expert shoe-fitter so they do not put pressure on a growing foot.

You may notice variations in walking styles of toddlers such as feet pointing inwards (in-toeing) or outwards (out-toeing), or tip toeing or flat feet. In many cases children will outgrow these walking styles but if these walking patterns persist, or your child is constantly tripping or clumsy with their feet, it is recommended to take your child to see a podiatrist.

Sitting positions are very important for toddlers. Discourage children from “frog” or “W” sitting with their knees turned in and their feet turned out. Encourage children to sit crossed legged.

School Age Children

Your child’s foot will grow rapidly in the school years – approximately 9mm per year to reach adult foot size by approximately 12-15 years of age. It is important at this developmental stage to frequently check the size of your child’s foot and make sure that they have correctly fitted shoes. Also look for signs of uneven wear patterns of your child’s shoes.

As children become more physically active and begin to participate in sports you may notice complaints such as heel pain or tired legs. Don’t dismiss your child’s consistent complaints of aches as “just growing pains”. They can sometimes be due to poor foot or leg posture and require assessment and treatment by a podiatrist.

Common Children’s Foot Problems:

Heel Pain or Severs Disease

Growing children within the age of 8-14 years of age can present and complain of heel pain. The most common cause of this is inflammation to the growth plate in the back of the heel bone (calcaneus) where the Achilles tendon attaches onto it. This is known as Sever’s Disease or calcaneal apophysitis (inflammation of the growth plate of the heel).

Sever’s Disease can affect one or both heels and will generally be aggravated by activities such as playing sport, running and jumping. It is commonly seen in children who play basketball, football, soccer or other sports that involve running. The heel will be painful when it is squeezed at the back. In severe cases the child may be limping.

The cause of Sever’s Disease is repetitive stress of the Achilles tendon pulling on the growth plate of the heel bone. The new bone forming is softer and becomes inflamed.

Over pronation (feet rolling inwards) will increase the stress on the growth plate so is often a major contributing factor to heel pain. In addition, tight calf muscles with growing also contribute to the condition.

Sever’s Disease treatment can help reduce pain and help maintain normal activity levels for children. These include:

  • Rest or reducing sporting activities for a short period
  • Footwear advice
  • Use of a heel lift to reduce the pull of the Achilles tendon on the heel bone
  • Stretching exercises for the calf and hamstring muscles, particular before and after sport
  • Orthotic insoles to control foot biomechanics and reduce stress on the growth plate of the heel

Heel pain that limits activity or is present all the time should be checked by a podiatrist.


Warts are caused by a group of viruses called HPV (Human Papilloma Viruses). They can occur anywhere on the skin and are commonly seen on the feet. Plantar warts are on the sole of the foot. They tend to be hard and flat with a rough surface. Because of their location, plantar warts can be painful to walk on.

Warts are contagious and are easily spread. The virus can thrive in warm moist areas such as swimming pool changing rooms and public showers, so this is a frequent source of warts developing on the feet.

Warts are common in children as they are still building their immune system and are therefore more susceptible to the virus.  As warts are spread by direct contact there are some important tips to stop your child spreading them;

  • Avoid touching the warts
  • Avoid bare feet (wear thongs around public swimming pools and in public showers)
  • Keep feet dry and clean

It is important to see a podiatrist to assess if the area of concern is actually a wart and not another common condition such as a callus or corn.

There are many different treatment options for warts that we discuss with you at Mooroolbark Podiatry. We can also work to reduce the pressure and pain that warts cause.

Flat Feet

The term “flat foot” refers to a foot that lacks an arch or collapses too far upon weight bearing. This is medically referred to as Pes Planus.

Young children commonly have low arches or flat feet because their joints are loose and they are flexible. The arch will begin to develop around four years of age and should be developed by the age of six.

Flat feet will not necessarily cause symptoms and will not necessarily require treatment. Often advice on strengthening exercises and recommendations for supportive footwear is all that is required. At times orthotic insoles are also recommended. If you have any concerns about the way your child is walking, or they are complaining of pain with activity, then it is important they be seen by a Podiatrist.

In toeing

In toeing (or ‘pigeon toed’) is when a person’s feet turn inwards. It is commonly seen in young children. It does not usually cause pain in children and most children will be able to walk and participate in sports without any difficulty. They may be prone to tripping or look awkward when walking or running.

In toeing can be caused by several factors:

  • Internal tibial torsion -the tibia twists inwards
  • Femoral anteversion – the femur twists inwards
  • Metatarsus adductus – the foot turns inwards or is C shaped (may develop from position in uterus)
  • W sitting – increases the internal rotation of the hip and knee

In toeing will often self correct as the child grows and the bone slowly untwists itself. However, if it is excessive or does not resolve by school age then treatment may be required.

This could include:

  • Changing sitting and sleeping positions
  • Exercises and stretches
  • Casting or bracing
  • Surgery in extreme cases