Foot Conditions
Children and Sports
Description
Sports and Your Children's
Feet:
Advice From The APMA
All parents know that children take to sports like ducks
to water. Almost as soon as they start to walk, they're chasing balls,
swinging sticks, and running races against nobody in particular.
Children's sports used to mean baseball, basketball,
or football. That's changed. Soccer has leapt onto the youth sports
scene, as have wrestling, tennis, and lacrosse with older children.
The starting age for training in individual sports such as swimming,
skating, track, and gymnastics grows younger every year.
Parents should encourage their children to participate
in sports, but never forget that competition should be fun. Too much
emphasis on winning can alienate a child from athletic competition.
Children active in sports programs will improve their
cardiovascular and musculoskeletal systems, coordination, and state
of mind. Participation in sports develops a sense of self discipline,
teamwork, and recognition of the importance of a healthy body --
good habits that last a lifetime.
Training Emphasis
Every child physically matures at his or her own rate,
and has a different degree of athletic ability. No amount of training
can improve a child's natural athletic ability, but training helps
improve coordination, and therefore performance.
Early training should emphasize proper technique and
basic movement skills in all sports, especially in children younger
than 10. Podiatric physicians, specialists in treating the lower extremities,
say children who concentrate on a single sport at too young an age
are more likely to develop injuries of the foot and ankle. Save specialization
in sports for the late teens, they advise.
Warming up before participating in sports is more important
for adults than children, but it helps loosen the muscles and prevent
injuries in athletes of all ages. Light jogging and smooth stretching
exercises (be sure not to bounce when stretching) are all that's necessary
for young athletes. Learning to stretch at an early age will set a
good pattern for sports activities as the body develops.
Footwear
Whether parents like it or not, part of a child's image
revolves around footwear. Expensive sneakers have become fashion statements
as much as athletic equipment. But for good foot health, the condition
of the shoe is more important than the price tag or brand name.
Podiatric physicians agree it's often better to buy
a child two $50 pairs of shoes than a single $100 pair, so the shoes
can be rotated, to avoid rapid wear deterioration. Excessive wearing
of the outsole, loss of shoe counter support, or wearing out in the
midsole indicate it's time to replace the shoes.
Because a child's feet are constantly growing, it is
important to allow at least one finger's width from the end of the
longest toe when buying shoes. Remember, proper fit is very important.
You can have the best shoe in the world, but if it doesn't fit right,
it doesn't do its job.
In the shoe store, children should put on both shoes,
with their athletic socks and the laces tied tight, for several minutes
to properly check the shoes' fit. Shop for shoes in the afternoon,
when the feet are naturally slightly swollen.
In young children, an "all purpose" sports shoe works
well for most sports. A running-specific shoe is not suitable as an
all purpose shoe; moving laterally in a running shoe is more difficult
and presents greater risk of injury for children. After the age of
10, sport-specific shoes can help improve performance and protect
the feet. With the exception of the running shoe, a degree of crossover
between sporting shoes is usually not harmful to the feet of a child
athlete.
Rubber cleats are not usually necessary for children
under 10, though they pose little potential harm for them. They are
most useful on a soft-field sport such as soccer. Podiatric physicians
recommend molded shoe rubber cleats rather than the screw-on variety.
Metal baseball spikes can be dangerous and should not be used until
the teenage years.
Growing Bones and Ligaments
The immature bones of children are different from those
of adults. The "growth plates" in children's bones do not finish closing
until age 15-17 in boys and 13-15 in girls. When stressed, these plates
are more susceptible to injury than the tendons and ligaments that
support the joints. Ligaments tend to "give" before bones in adults.
Podiatric physicians warn repetitive overuse can cause
inflammation of the growth plates. They advise parents to promote
diverse physical activities for their children rather than one sport.
This is especially important with individual sports such as running,
gymnastics, and tennis, which require long hours of practice.
Statistics show children who concentrate on just one
sport for long hours at a time are setting themselves up for injuries.
Because of the susceptibility of bones with open growth centers to
overuse injuries, sponsors of the Boston Marathon recently increased
the minimum age to participate from 16 to 18.
A sports medicine podiatrist can offer a thorough examination
of the entire lower extremity, and identify a leg length imbalance,
weakness, or biomechanical imbalances that may need to be addressed
to prevent injuries on the athletic field.
Injuries and Treatments
Many children suffer from mild "torsional" imbalances,
commonly known as in-toeing and out-toeing. Most children outgrow
these imbalances without medical treatment. However, if a child has
obvious torsional imbalances, he or she may be more susceptible to
injury. If that is the case, keep a close eye out for foot and ankle
injuries associated with sports activity. Foot injuries commonly seen
in very active children include:
Ankle Sprains. In older children, stretched
or torn ligaments in the ankle, known as sprains, are more common
than fractures. A sprain may cause extensive swelling around the ankle
just like a fracture. Immediate treatment is crucial to quick healing.
A podiatric physician can provide treatment as well as recommend balancing
and strengthening exercises to restore coordination quickly.
Fractures. Fractures from overuse in child-athletes
are commonly seen in podiatric medical offices. Growth plates are
particularly susceptible to injuries, but mid-shaft fractures of the
bone also occur. If a fracture is not severe, rest and immobilization
may be the best treatment. More complicated injuries may require casting
or surgical correction. If swelling and pain persist, see a podiatric
physician.
Sever's Disease. An inflammation of a growth
plate, Sever's Disease is often felt as pain behind the heel caused
by inflammation of the apophysis, a growth center where a tendon is
attached to the bone. Rest, ice, and heel lifts are usually prescribed.
Shin splints and stress fractures. Shin splints
are microtears or inflammation of the anterior leg muscles, as are
Achilles tendon pulls in the posterior region of the leg. Again, rest
is most important in healing these injuries. If pain is persistent,
see a podiatrist, who can recommend strengthening exercises, certain
shoes, or, if indicated, prescribe custom-made shoe inserts known
as orthoses.
A Word to Parents
All parents want to see their children do well in sports.
But putting too much pressure on a child to become a star athlete
may result in both physical and emotional injury to the child. A child
should enjoy playing a sport, but if forced, could be turned away
from all sports for a lifetime.
Especially with individual sports such as swimming,
figure skating, and gymnastics that require long hours of practice
every day, be certain the child's heart is in the endeavor, not just
yours. When it comes to sports, overzealous parents can potentially
do their children more harm than good.
Information provided by the American Podiatric Medical Association
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