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Lower Limb and Foot Problems in Children

Children can be affected by poor biomechanics just as adults can. Poor biomechanics in children can result in the following lower limb and foot problems:

Heel Pain - Sever's Disease (Calcaneal Apophysitis)

Sever's Disease is more commonly seen in boys than girls but is possible in both sexes. It is most commonly seen between the ages of 10 to 14 years old. Sever's Disease is a disturbance to the growth plate at the back of the calcaneus (heel) where the strong Achilles tendon attaches. The growth plate is the area on all long bones where bone growth occurs as a child matures; it is also a weak area of the bone.



  • Pain, swelling and redness at the back of the heel.

  • Limited mobility


Knee Pain - Osgood-Schlatter's Disease


Osgood-Schlatter's disease is a condition that affects the insertion of the patellar tendon at the tibial tuberosity and is probably the most frequent cause of knee pain in children. The condition occurs most commonly in children between the ages of 10 and 15 years old but it can occur in younger children. It is more common in boys but girls are also susceptible to its debilitating effects.



  • Pain, swelling and tenderness just below the knee joint

  • Many children first signal the start of the problem by rubbing the top of their "shinbones" with their hands


Juvenile Rheumatoid Arthritis (JRA)


Juvenile Rheumatoid Arthritis (JRA) is the most prevalent form of juvenile arthritis. It is usually seen in children under the age of 16 years old. JRA is an autoimmune disorder, which means that the body mistakenly identifies some of its own cells and tissues as foreign.


  • Persistent joint swelling, pain, redness and joint contracture/stiffness

  • Possible growth problems

  • Limited mobility, morning stiffness

  • Growth in affected joints may be too fast or too slow, causing one leg or arm to be longer than the other


Pedorthic treatment may include:
  • Foot and lower limb exam

  • Custom-made foot orthotic or over-the-counter device

  • Modification of footwear

  • Recommendation of appropriate and proper-fitting footwear


Pedorthic Pointers for Patients


  Video: Orthotics and Shoe Shopping Tips for Kids










For some diseases or injuries affecting children's lower limbs, time and rest are the most important factors in the recovery process. Some conditions will self-resolve with time as the child grows. During that time, measures that can be taken to help decrease pain until healing occurs include:

  • For Sever's Disease, adding heel lifts to shoes to help lessen the strain on the back of the heel

  • Ensuring the foot is in an optimal alignment - and not causing undue rotation of the lower leg nor stress to the tibial tuberosity (the bony protrusion at the top of the tibia bone in the lower leg located just underneath the kneecap) can help with Osgood Schlatter's disease

  • Accommodating painful joints, by using softer materials in orthotics and selecting appropriate footwear, can be helpful for the child managing Juvenile Rheumatoid Arthritis

  • Buying shoes that fit perfectly. It is not a good idea to buy shoes that a child will "grow into." A shoe that is too big allows for a sloppy fit and poor support which may aggravate problems

  • Not using hand-me down shoes for children as the wear patterns already created by previous owners will not allow for the best support possible for the child

  • Canadian Certified Pedorthists may recommend an over-the-counter device or a custom-made foot orthotic to help relieve pain caused by injury or unusual alignment of the bones of the foot.

Footwear is always a key component for anyone dealing with lower limb pain and injury. Your Canadian Certified Pedorthist can help determine an appropriate footwear style and fit for your child's condition. When buying children's shoes it is important to remember to look for the same features as we recommend for adults.


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