Use extra caution when going barefoot

We know that kids like to go barefoot as much as possible. However, there is always a risk that going barefoot can cause injury. Below is an article written by Robert Weiss on August 3, 2009.

Going barefoot, whether it's in spring or summer or all year round, can cause a multitude of injuries. Most injuries are seen in the summer months. Some of the most common barefoot injuries are lacerations and abrasions, as they relate to glass and sharp objects (such as seashells) on the beach. If dirt or sand enters into the wound it can become painful and get infected. With deep lacerations, it maybe necessary to get a tetanus injection or a few stitches, which will certainly slow you up and keep you out of the water during the summer months. Those people diagnosed with diabetes are more prone to infection from a cut and have a more difficult time healing the infected wound. This is due to circulation of the lower extremities in the more advanced cases. If it's a minor cut, the individual will be fine after the foreign body is removed and the wound is cleaned with antiseptic and topical antibiotic cream. Sometimes, dry sterile dressings are helpful. But, if the wound is deep and bleeding and doesn't stop after 10-15 minutes with pressure applied, then it is time to seek emergency medical help.

Columnist Robert Weiss, a sports podiatrist, was a member of the Medical Advisory Committee of the 1984 and 1988 Olympic Trials and has a practice in Darien, The Foot & Ankle Institute of Darien. His column runs every other Thursday in The Hour. For more information, visit his Web site at www.therunningdoctor.net

If your child has an injury to their foot, do not delay in getting it treated. Call the office for an appointment 419-423-1888.

Common Childhood Foot Complications - Continued

STRESS FRACTURE - Pain; Swelling
RECOMMENDED TREATMENTS - Immobilization; Surgery

SEVER'S DISEASE (HEEL PAIN) - Pain with side-to-side pressure of the heel; Pain with activity; Pain with soccer or baseball cleats
RECOMMENDED TREATMENTS - Rest; Ice; Shoe change

TOE-WALKERS - Walking on toes
RECOMMENDED TREATMENTS - Stretching exercises; Neurological exam; Surgery in severe cases

PLANTAR FASCIITIS (HEEL PAIN) - Pain when standing or walking
RECOMMENDED TREATMENTS - Stretching; Arch supports; Custom foot orthotics

ANKLE/FOOT FRACTURE - Pain in the area of fracture; Protruding bone
RECOMMENDED TREATMENTS - Casting, Rehabilitation

ANKLE SPRAIN - Pain, Swelling, Bruising
RECOMMENDED TREATMENTS - Immobilization; Casting; Bracing

PLANTAR WARTS - Painful thickening of the skin; Hard and flat; elevated surface most often on the sole of the foot
RECOMMENDED TREATMENTS - Mild acids; Lasers; Freezing temperature; Surgical removal; Medication

As always, if you notice any of these symptoms, please call the Office for an appointment - 419-423-1888.

Common Childhood Foot Complications

As early as birth, foot complications can present themselves in children. Some complications, such as flatfoot and ingrown toenails, can be inherited or caused in the womb. Others can occur as children begin their walk through life, from the occasional fall to an injury suffered playing a sport. No matter the cause or severity of the problem, the health of a child’s feet should not be taken for granted. However, according to an American Podiatric Medical Association (APMA) survey of parents with children under the age of 18, only 35 percent said that they would not be motivated to take their child to a doctor’s office for foot or leg pain treatment. Furthermore, only 25 percent of those surveyed would take their child to see a podiatrist—a foot and specialist. Member podiatrists from the APMA can help make sure your child stays on his/her feet by offering expert medical diagnosis and treatment options for all issues associated with the feet. From the time a child begins to walk, he/she should be seen by a podiatrist who can make sure his/her feet are progressing normally, especially if there is a family history of foot problems. The following list details common inherited and developmental foot complications in children, possible signs and symptoms and treatment options.

CLUBFOOT - Hooked foot that twists inward and downward
TREATMENTS - Casting; Surgery in more severe cases

METATARSUS ADDUCTUS (MTA) - Front of foot bent inward at the instep resembling the letter "C"; Excessive tripping when walking
TREATMENTS - Stretching exercises; Shoe option that are straight; Serial casting; Surgery in more severe cases

POLYDACTYLY (Multiple Toes) - Eleventh or twelfth toe
TREATMENTS - Remove extra toes if they interfere with walking or wearing shoes

SYNDACTYLY (Webbed Toes) - Skin fails to separate between the toes
TREATMENTS - Surgical separation of webbed toes

FLATFOOT - Pain; Slow walking; Difficulty keeping up with other children
TREATMENTS - Custom foot orthotics; Change in the type of shoe; Surgery in some cases

IN-TOEING -One or both feet pointed inward; Tripping; Sitting on knees in "W" position
TREATMENTS - Exercises (first position ballet, sitting Indian style, riding "big wheel"); Casting; Bracing

ACHILLES TENDONITIS - Pain with activity at the back of the leg and heel; Swelling
TREATMENTS - Rest; Icing; Stretching; Physical therapy; Heel lifts; Custom foot orthtics; Soft casting

As always, if you notice any of these symptoms, please call the Office for an appointment - 419-423-1888.

Frequently Asked Questions

Pregnancy and Pediatric Foot Care

1. How does pregnancy impact the feet?
Pregnancy can impact the feet numerous ways from over-pronation and plantar fasciitis due to
increased body weight to an increase in foot size related to hormonal changes and leg
cramps because of impeded circulation.
2. Is it normal for my baby’s feet to look discolored, wrinkled or for his/her skin to peel when he/she is born?
Babies spend anywhere from nine to10 months in a shelter of protective fluid. The feet need just as much time to fill out and turn a normal color as the rest of the body. Once you give birth, your OB and then later your pediatrician will look for obvious abnormalities of your baby’s feet and legs.
3. Are there certain things I can do to care for my baby’s feet?
Caring for your baby’s feet is no different than the care you provide to the rest of his/her body. Trim your child’s toenails with baby nail clippers, making sure to cut straight across to prevent ingrown toenails. Also, be sure to thoroughly dry your baby’s feet after a bath. Additionally, purchase items, such as an activity gym, which will allow your baby to move his/her legs and feet around. This will help him/her strengthen his/her muscles in preparation to walk. Try SmartKnit Kids Seamless Sensitivity Socks* – these soft, anti-microbial socks don’t wrinkle or bunch and are proven to reduce irritation in your tot’s tootsies.
4. At what age should my child take his/her first step?
When physically and emotionally ready, your child will walk. Comparisons with other children are misleading, since the age for independent walking ranges from 10 to 18 months.
5. When should I put my baby in his/her first pair of shoes?
When your child first begins to walk, shoes are not necessary indoors. Allowing your youngster to go barefoot or to wear only socks helps the foot to grow normally and to develop its musculature and strength, as well as the grasping action of toes. Of course, when walking outside or on rough surfaces, babies' feet should be protected in lightweight, flexible footwear made of natural materials. Try Pediped’s* – designed for infants and toddlers up to two years old, these soft, hand-stitched shoes provide a safe environment for tiny toes while allowing plenty of room for foot growth and muscle development.
6. When should I take my child to child to see a podiatrist?
The APMA recommends having your child examined by an APMA member podiatrist once he/she begins to walk to make sure his/her feet are progressing normally, especially if there is a family history of foot problems. Many APMA member podiatrists specialize in pediatrics. You can search for a podiatrist in your area by visiting APMA’s Web site, www.apma.org, and clicking on "Find a Podiatric Physician." You will find a list of podiatrists who you can call to see if they specialize in pediatrics.
7. When is a child’s foot fully developed, and why is this important?
Full skeletal maturity takes place in most individuals between the ages of 18 to 23 years of age. Foot maturity continues while many children are active on his/her feet. It is important to have your child’s feet checked regularly by an APMA member podiatrist.
8. What steps should be taken to make sure a child’s feet are not at risk when participating in sports?
When your child participates in sports, make sure they wear sport-specific shoes that fit properly. They should also warm up and cool down before and after participating in a sport and avoid poor outside playing conditions, such as very wet grass. *These products have been awarded APMA’s Seal of Acceptance. For more information about APMA’s Seal, visit www.apma.org/seal.

Baby's First Shoes

It is ill-advised to force a child to walk. When physically and mentally ready, the child will walk. Comparisons with other children are misleading, since age for independent walking ranges from 10 to 18 months.

When a baby first begins to walk, shoes are not necessary indoors. As a toddler, walking barefoot allows the youngster's foot to grow normally and to develop its musculature and strength, as well as the grasping action of toes. Of course, when walking outside or on rough surfaces, babies' feet should be protected in lightweight, flexible footwear made of natural materials.

If you have any questions or concerns about what appropriate footwear to provide for your child, please call the office to set up an appointment (419-423-1888).

Your Baby's Feet

The human foot - one of the most complicated parts of the body - has 26 bones, including an intricate system of ligaments, muscles, blood vessels and nerves. Because the feet of young children are soft and pliable, abnormal body forces can cause deformities.



A child's feet grow rapidly during the first year. For this reason, podiatric physicians, also known podiatrists, consider this period to be the most critical stage of the foot's development.



Here are some suggestions to help ensure normal development:

1. Look carefully at your baby's feet. If you notice something that does not look normal to you, contact an APMA podiatric physician (Dr. Vail). Many deformities will not correct themselves if left untreated.
2. Keep your baby's feet unrestricted. No shoes or booties are necessary for infants. These can restrict movement and can inhibit toes and feet from normal development.
3. Change the baby's position several times a day. Lying too long in one spot can put excessive strain on the feet and legs. Be sure to limit how much time your baby spends standing in an activity center to no more than 15 minutes at a time.

As always, if you have any concerns or questions, please call our office to set up an appointment to see Dr. Vail (419-423-1888).

More Children Shoe Tips

As a child's feet continue to develop, it may be necessary to change their shoe and sock size every few months to allow room for the feet to grow. Although foot problems result mainly from injury, hereditary factors, deformity, or illness, improper footwear can aggravate pre-existing conditions.

Before parents invest in a new pair of children's footwear, some foot factors need to be considered:

Shoes that don't fit properly can aggravate the feet. Always measure a child's feet before buying shoes and fit the shoe to the foot.

Never hand down footwear. Just because a shoe size fits one child comfortably doesn't mean it will fit another the same way. Not to mention that the practice of sharing shoes can spread fungi like athlete's foot and nail fungus.

Watch for signs of irritation. Redness is a sure sign that a shoe is too tight or too loose. If your child always wants to remove one or both of his/her shoes, this may be an unspoken sign that the shoes don't fit properly.

Examine the heels. When children begin to show in-toeing, they may wear through the heels of their shoes much quicker that outgrowing the shoes themselves. Uneven heel wear can indicate a foot problem that should be checked by a podiatrist.

Dr. Vail wants to ensure that your child's feet are developing properly and are as healthy as possible. If you have any questions or concerns about your child's feet, please call the office for an appointment - 419-423-1888.

Advice for Parents

Problems noticed at birth will not always disappear by themselves. You should not wait until the child begins walking to take care of a problem you've noticed earlier. It is best to take action when the child is a toddler to ensure better responsiveness to conservative treatment options.

Remember that lack of complaint by a youngster is not a reliable sign. The bones of growing feet are so flexible that they can be twisted and distorted without the child being aware of it.

Walking is the best of all exercises, according to podiatric physicians. They also recommend that walking patterns be carefully observed. Does the child toe in or out, have knock knees, or other gait abnormalities? These problems can be corrected if they are detected early.

With the exception of infancy, going barefoot is not encouraged among children. Walking barefoot on dirty pavements exposes children's feet to a variety of dangers including infection through accidental cuts, sprains or fractures. Another potential problem is plantar warts, a condition caused by a virus which invades the sole of the foot through cuts and breaks in the skin. They require extensive treatment and can keep children from school and other activities.

Be careful about applying home remedies to children's feet. Preparations strong enough to kill certain types of fungus can harm the skin.

Dr. Vail wants to ensure that your child's feet are developing properly and are as healthy as possible. If you have any questions or concerns about your child's feet, please call the office for an appointment - 419-423-1888.

Five Shoe Buying Tips for Children

The following steps are recommendations from the American Podiatric Medical Association:

1. Take your child shoe shopping. It's important to have your child's feet measured before buying shoes. Letting a child have a say in the shoe buying process promotes healthy foot habits down the road.

2. Shop for shoes later in the day. Feet tend to swell during the day; it's best to be fitted while they are swollen.

3. Buy shoes that do not need a "break-in" period; shoes should be comfortable immediately.

4. Always buy for the larger foot. Feet are seldom precisely the same size.

5. Have your child try on shoes with socks or tights, if that's how they will be worn.

Kids and Sports

Sports play a significant role in millions of American children’s lives, whether on a team or played as individuals. Parents should be mindful of sports that require a substantial amount of running and turning, or involve contact. These can easily translate into injuries. Protective taping of the ankles is often necessary to prevent sprains or fractures. Parents should consider
discussing these matters with their family podiatric physician if they have children participating in active sports. Sports-related foot and ankle injuries are on the rise as more children participate actively in sports.

Buying a sport-specific shoe – a shoe designed for the exact sport your child will be participating in – not only improves your child’s performance on the court or field, but also helps keep him/her free from serious foot and ankle injuries.

Don’t Forget the Socks!

Without the right sock, even the best athletic shoe won’t score points on the field or off. If your child exhibits signs of hyperhydrosis (excess sweating) or bromhydrosis (foot odor), selection of the appropriate athletic sock may reduce incidences of these conditions. The right athletic sock should be made of a natural/synthetic blend, as this helps “wick” away moisture best, and not contain any large seams that can cause blisters or irritation.

Keep Your Kids Healthy!

As school begins a new year, it is always to keep your child's health in check. If you are new to the area and are looking for a doctor, below is a list of local pediatricians.

Robert Beck
Blanchard Valley Pediatrics
1818 Chapel Dr. Suite D
419-424-1922

Jana Doone
Pediatric Hospitalists of Northwest Ohio
1900 S. Main St.
419-423-5346

Martin Hanawalt
Pediatric Hospitalists of Northwest Ohio
1900 S. Main St.419-423-5346

Cheryl Huffman
Caughman Health Clinic
1800 N. Blanchard St. Suite 121
419-427-0809

Ramalingam Maruthavanan
Pediatric Hospitalists of Northwest Ohio
1900 S. Main St.
419-423-5346

Ami Orr
Blanchard Valley Pediatrics
1818 Chapel Dr. Suite D
419-424-1922

Andrew Ritz
Blanchard Valley Pediatrics
1818 Chapel Dr. Suite D
419-424-1922

Donald Savage, Jr.
Blanchard Valley Pediatrics
1818 Chapel Dr. Suite D
419-424-1922

Lynn Taylor
Physicians Plus
3949 N. Main St.
419-423-3888

Thomas Wojciechowski
Pediatric Hospitalists of Northwest Ohio
1900 S. Main St.
419-423-5346