Tuesday, September 22, 2009

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.


  1. Our AYSO league just replaced our grass with artificial turf. Yesterday was my son's first game (he's a forward...lots of running). He came home with a blister on his baby toe and complained about the heat that was being generated by the astroturf. Today, he had his second game of the season and came home with quarter size blisters. We had his feet sized a couple of weeks ago and his cleats fit fine and generate no problems on grass. (He's had them for about 6 months.) He wears orthodics that were molded to his feet due to flat feet and pronation. Could the heat generated from the astroturf (it was about 80 degrees today and yesterday)have caused the blisters? Could the orthodics (they are plastic) have generated additional heat? What can I do to cool down his feet so he can continue playing? I am looking into purchasing some astro turf soccer cleats, but I am hesitant about purchasing new orthodics. These are only a few months old and were a mint. Any other ideas I could try?

  2. Anonymous,
    Thank you for your interest in our blog. This is an in depth post, with many questions and we will do our best to answer all of them.

    First of all the transition to turf can be difficult. I played collge football, where most of the surfaces we played on were turf and had my first experience with Turf late in my high school career. This surface brings about many unique concerns. Your son may either be playing on astroturf, which is the older version of the artifical surface (think the Brady Bunch's back yard), or on speed turf, the newer version of this surface. Speed turf is generally a synthetic grass, complete with individual blades, and it is lined with rubber pellets to help soften your contact on the surface. It tends to be less punishing on the athlete's body. Both surfaces do retain the sun's heat and can get quite hot. My college stadium is in a valley, flanked by hills and bleachers. The surface on the field can really heat up. The air temperature four feet above the surface reached 123 degrees during one two-a-day practice in August! Your first concern is hydration. Your child needs to hydrate before, during, and after his activity so he does not get dehydrated. You should monitor your child's fluid intake carefully to ensure that he is consuming enough water.

    As far as the heat from the field affecting his orthotics, I do not believe that is very likely. If they are custom molded orthotics, then they are made of specific materials designed to last through lots of use. If they are a few month old, they should still be in good condition. If they are feeling hot in your sons cleats, try having him remove his cleats during breaks (such as half time) and remove his orthotics from them. This should give his feet a little chance to cool off, being exposed to the air. It will also allow some time for heat to escape from the cleats themselves and away from the orthotics. It may also be a good idea for your son to change socks between the periods. It will help air out his feet (and lower legs when wearing soccer sockes) and remove a lot of the moisture from his feet and shoes.

    Removing the moisture may also help with the blistering. There may be a few possible causes for this blistering. Obviosuly there is friction in his shoes, which is causing the blister. It is unlikely his cleats are not sized right, as they are fairly new. But he may have hit a growth spurt and already be outgrowing his cleats. Make sure they are sized right, and have plenty of room for his toes. Many cleats, especially soccer cleats, can have narrow toes. This may be why his small toe is now rubbing against his shoe. The excess moisture in his socks from the increased heat of the field can also exacerbate his blister problem, as the skin not only passes by the shoe, but has a tendency to stick to it due to the moisture. Changing his socks can help remove this moisture, as can applying foot powder to his shoes before the game and during the intermission. Do not feel embarrased by paying attention to your child's cleats and socks during half time. Most of the professional athletes you see on television make all kinds of adjustments to their equipment during the half or time-outs. You just don't see these events as they aren't broadcast. Even college athletes make changes, like socks, adding foot or talcum powder to equipment, changing undershirts- I've even seen a player change his pants and all his leg pads between halves of a football game! Taking the time to address these concerns could be the difference in your son's comfort during the game. And when he is not focused on his feet, he will be more focused on the game.

  3. (continued discussion on astroturf concerns)

    Lastly, the turf may be causing the blisters. One of the advantages of playing on an atrifical surface is the increased traction. It makes athletes a little faster, and makes wet conditions a little more manageable. But this traction also means your child will be stopping faster. When he changes directions, his feet will slide into the sides and front of his cleat faster and with greater force. Compare this to a care slamming on the breaks at 60 miles an hour. If the car has old breaks, you will not feel nearly the same forward force as if the car has brand new breaks. It is the same with your son's feet sliding inside his cleats. This increased traction means increased momentum and increased stopping power. You can try to add a little extra padding to his toe around the blister. Try an adhesive backed blister pad, or a gel bandaid. You can also try having your son wear a second pair of socks. I spent a football season with a deep heel bruise which meant that I had a padded heel and wore two pairs of socks to every game and practice.

    If you have any other questions, we always encourage you to call the office and make an appointment. The doctor's expertise goes beyond yours and mine. Perhaps you are still concerned about the orthotics and want to have them assesed, or you want Dr. Vail to look at your son's blisters. We can do either of these things. Whenever you are experiencing foot or ankle problems, your best course of action is to contact your podiatrist for an appointment.


Happy Feet...

Happy Feet...

= Happy Kids...

= Happy Kids...

= Happy Family!

= Happy Family!