6 different pictures of youth athletes engaging in various sportsAs a parent of kids who play sports, you want to do everything possible to make sure your child has the best equipment and plays safely. While there's been a lot of news coverage about the problems kids can suffer as a result of concussions, there's scant information about the impact of foot and ankle injuries on youth athletes.

That's why I wrote this guide. I see far too many kids in my office with foot and ankle conditions and injuries that could have been avoided.

Heel Pain in Youth Athletes

While kids can develop the same type of heel pain as adults, namely plantar fasciitis, a condition called Sever's disease is much more common, particularly among youth athletes. This condition affects kids ages 8-14 who have an open growth plate on their heel bone. When this plate is still open it's susceptible to bruising and inflammation during activities like soccer.

To address the problem, I advise young athletes and their parents to ease up on their activity level, reduce their inflammation and pain through use of anti-inflammatory medications and ice, use of heel lifts to help absorb impact, use of over-the-counter inserts or custom orthotics, and go for physical therapy.

To prevent Sever's disease in your youth athlete, start by purchasing supportive shoes that are designed for their particular sport (see below for more information), stretching the Achilles tendon to reduce stress on the heel if they are prone to this condition, and avoiding play beyond your child's abilities.

Stress Fractures in Youth Athletes

Another overuse injury common in young athletes are stress fractures. When muscles are too tired to take on the additional stress of play it's absorbed by the bones. Stress fractures can occur in the lower legs, ankles, and feet.

Youth athletes most at risk are those who play sports that involve running, jumping, and repetitive movement such as gymnastics, basketball, and track and field. Ramping up sports activity too quickly, without rest in between to adequately condition the body, can also increase the chance of a stress fracture.

To prevent stress fractures in youth athletes make sure they do the following:

  • slow and proper conditioning for their sport

  • eating balanced, nutritious meals rich in calcium and Vitamin D

  • drink plenty of water throughout play

  • adequate warm-up and cool-down

  • stop playing when in pain and visit to podiatrist

  • alternating types of physical activities

  • go for a sports physical before the season starts

  • replace athletic shoes every 500 miles

Ankle Sprains in Youth Athletes

Ankle sprains are common in youth soccer, basketball, and other sports. In fact, researchers have estimated that ankle injuries account for 10 to 30% of all sports related injuries in young athletes. It's almost impossible to tell if your youth athlete has broken a bone or sprained an ankle without imaging--these include X-rays for identifying broken bones and ultrasound to find out the degree of soft tissue damage. Sometimes an MRI will be necessary.

While minor injuries can be treated with rest, protection of the site, and time away from the field, more severe ankle sprains will require immobilization and also rehabilitation through physical therapy. Sometimes surgery will be required.

Ingrown Toenails in Youth Athletes

Another common problem in kids who play sports are ingrown toenails. Tight shoes or cleats in soccer and other sports combined with repetitive actions such as kicking are the major culprits.

Ingrown toenails need to be treated by a podiatrist. To help ease your child's pain in the meantime, soak their foot in room-temperature water with Epsom's salt and gently massage the side of the nail fold to help reduce inflammation.

Nail surgery for treatment of an ingrown nail can be done in the office. Prevention of ingrown toenails includes wearing shoes that fit properly, avoiding tight socks, purchasing (soccer) cleats that aren't too tight, and proper toenail trimming (trim straight across, no rounded corners).

MRSA in Youth Athletes

MRSA stands for methicillin-resistant staph aureus. Methicillin was the antibiotic used to treat staph aureus in the past but now this new form is resistant to it making it much more difficult to treat and more dangerous to the person who gets it. MRSA is highly contagious and can be easily transmitted through body contact which is one of the reasons athletes in high contact sports such as football, basketball, and soccer need to be educated about it.

Fortunately, there are specific symptoms for young athletes and their parents to watch for and specific things that can be done to prevent it.

The symptoms of MRSA include:

  • Swollen, painful, red bumps
  • Heat or warmth
  • Pus or drainage from a wound
  • More advanced signs are fever, chills, body aches, rash, or shortness of breath and can mean the infection has entered the bloodstream (be aware that some of these symptoms mimic the flu)

To prevent MRSA:

  • Good hand hygiene is extremely important. Kids should wash their hands before and after workouts and practice.
  • Scrapes, cuts, and injuries should be washed thoroughly and bandaged.
  • Kids should not share soap, towels, or razors.
  • Athletes need to shower immediately after practice.
  • Athletic equipment should be wiped down before and after use

Shopping for Athletic Shoes

Buying proper athletic shoes for your sports minded child is one of the most important things you can do to prevent them from getting foot and ankle injuries on the field.

  • Buy new shoes-it’s important to start out the season with a brand new pair of shoes. Old shoes will not provide the support your child needs to avoid injury and be his or her best on the field.

  • Get your young athlete’s feet measured- these days many parents purchase kids shoes off the shelf or online. Although this is an easy solution it circumvents the need to get your kids feet measured properly. Getting a good fit is always a good idea but its imperative when your kid plays sports. In addition to getting their feet measured, be sure that the shoe is at least one thumb’s length between the top of the big toe and the end of the shoe. Always choose the larger size if one foot is larger than the other.

  • Buy the shoe designed for their sport-choosing the right shoe for their sport is essential. Athletic shoes are designed specifically for the sport they are intended, providing just the right stability and flexibility.

  • Check shoe stability-don’t just go by the name brand of shoe when you purchase it. Even great name brands provide a range of support and may not meet the requirements your child needs. Test the shoe by holding it by the heel and toe. Attempt to bend it in half. It should only bend at the ball of the foot, not in the middle. Then try and twist the shoe. It should not easily twist from side to side.

Checking the Field to Prevent Falls

Many sports-related foot and ankle injuries can be avoided by checking the field before play. The field should be checked for dips, holes, stray objects, and too much water.  Alert coaching officials to any irregularities.

If your youth athlete is experiencing foot or ankle pain, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.
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