Preventing Sports Injuries in Children Starts Young

I just read a great article online about preventing ACL injuries in young athletes, especially girls. It's right here (preventing sports injuries in children) and it brings up some very important points about the alarming increase in sports-related injuries in student athletes. There's no doubt that youth sports are becoming more competitive, more aggressive, and having a greater incidence of injury on young athletes. The article points out the important perspective of prevention in young athletes to help avoid some of the most common injuries. It discusses the new trend in orthopedics toward considering the body as a whole rather than an isolated joint when it comes to injury.

As the old song goes, "the knee joint's connected to the ankle joint," and on and on. If an athlete suffers a tendency toward knee injuries,orthopedists are looking more closely at the overall gait and starting with the foot. If the foot is not stable, then the whole leg is at risk for injury. Taking simple measures to align the foot and ankle can mean prevention of serious injuries to the ACL and other major joints. One of those steps is an arch support or orthotic. And, from a prevention perspective, the earlier you start this process, the better.

The article mentions the fact that even an athlete as young as nine years can begin doing basic strength training exercises using their own body as resistance. Building stronger supporting muscles, and getting the right support in shoes can have a significant impact on injury prevention. The earlier you begin with getting a child's foot balanced and stable, the more likely they will be able to avoid painful injuries later on. It seems really straightforward, and I encourage all parents with child athletes to take a closer look at how the foot is being supported. It may prevent your child from spending part of their youth sports career on the sidelines.

Dr. Manolian Weighs in on Toe Walking

Recently, a parent was concerned about her child's toe walking tendencies. The child was being evaluated by a pediatrician, and the behavior fell within the normal range at this age (3 years). We thought it might be helpful to get a podiatrist's opinion as well. Here is Dr. Manolian's response on the topic:

Toe walking is very common in young children and early walkers. Most children usually grow out of it. One of the causes can be due to a tight Achilles tendon. It is always important to seek medical evaluation from a physician who can determine the root cause. They may suggest exercise or physical therapy if there is a physical cause for the toe walking.

In addition to stretching exercises, many children who toe walk benefit from arch supports, or comfort insoles, that will produce plantar (bottom of the foot) contact, which tends to enhance normal walking patterns. If the child resists use, try to introduce the insoles gradually.

We Want To Change the Way You Think About Kids' Feet

I've been thinking a lot about how we view kids' feet and all the commonly held views on kids' feet that, as new parents, we tend to absorb while we're learning the ropes of parenting. Things like, "let them walk barefoot as often as possible," and "don't worry if they're walking a little funny, they'll grow out of it." We just shrug and say "Okay, the experts are saying this so I guess it must be right."

Well, I've always had issue with the first comment - walking barefoot. That works great for my friends Dave and Tami in Hawaii, where the kids spend much of their day on the beach or outside in general. Up here in the Northeast, we tend to have frozen tundra from November to March, so barefoot outside is impossible, and inside it's still too cold for little toes on those hardwood floors!

Yes, there is something to be said when a child is first learning to walk about letting their feet touch the ground and learn how to work the muscles to provide the stability they need to move forward. However, once they've got it down, then it's more important to find them shoes that continue to enhance that muscle and bone development while protecting them from the elements.

As for the outgrowing comment, while most kids sometimes do walk funny for the first few years, they may "outgrow" the behavior, but sticking them in shoes that don't have adequate cushioning arch support or stabalizing heel support can very well drive them down the path that many of us adults are finding - back aches, knee pain, foot pain. Much of this can be traced back to our childhoods when we were wearing shoes that didn't have the right inner support and cushioning to let our bones grow and muscles develop correctly.

So, I disagree with the "experts" on this one - I've seen firsthand that putting Arch Angels in my children's shoes have made a difference today in their level of comfort and stamina, and I strongly believe that that difference will lead to fewer long-term problems with their feet, knees, backs and overall physical health.

What do you think? Do you follow the conventional wisdom about minimal support when they're in their formative years? What did your pediatrician say to you if you brought up the fact that Timmy seems to walk on the outsides of his feet? I'd love to hear your comments!