Children’s Foot & Ankle Problems 2026 | Podiatrist

Condition	Age Range	Presentation	Cause	Treatment
Sever Disease (Calcaneal Apophysitis)	8-14 years; growth spurt	Posterior heel pain; worse with sport; squeeze test positive	Traction on open growth plate by Achilles	Heel lift; activity modification; calf stretching; resolves at skeletal maturity
Iselin Disease (5th Metatarsal Apophysitis)	8-13 years	Lateral foot pain at 5th metatarsal base; sport-related	Peroneus brevis traction on open apophysis	Rest; CAM boot if severe; heel cup; resolves with maturity
Flexible Flatfoot	All ages; most common under 6	Arch absent in standing; reconstitutes on tiptoe; asymptomatic in most	Ligamentous laxity; developmental	Observation if asymptomatic; orthotics if pain; HyProCure if symptomatic after 8 years
Tarsal Coalition	8-16 years; pain onset in adolescence	Rigid flatfoot; peroneal spasm; restricted subtalar motion	Congenital cartilaginous or bony bar	CT/MRI to diagnose; resection if <50% joint; arthrodesis if severe
Intoeing (Metatarsus Adductus)	Birth to 5 years	Feet turn inward; C-shaped medial border; flexible vs rigid	In utero positioning; metatarsal adduction	Stretching for flexible; serial casting for rigid; resolves spontaneously in most
Clubfoot (Talipes Equinovarus)	Birth; congenital	Plantar flexed; inverted; adducted; supinated — “CAVE”	Congenital; multifactorial genetics	Ponseti serial casting x5-7 casts; Achilles tenotomy; Denis-Browne bar
Ingrown Toenail (Pediatric)	Any age; teen peak	Lateral nail border pain; erythema; granulation tissue	Improper trimming; tight shoes; nail anatomy	Conservative if early; partial nail avulsion + matrixectomy if recurrent

Red Flag	Possible Diagnosis	Action Required
Unilateral flatfoot (vs bilateral)	Tarsal coalition; accessory navicular; posterior tibial tendon problem	CT/MRI; podiatric evaluation
Night pain; pain at rest	Bone tumor (osteoid osteoma); leukemia; infection	Urgent imaging + oncology consult
Progressive cavus foot; especially unilateral	Charcot-Marie-Tooth disease; spinal cord lesion	Neurology; EMG/NCS; MRI spine
Toe walking persisting past age 3	Cerebral palsy; Duchenne muscular dystrophy; autism spectrum	Pediatric neurology; Achilles evaluation
Warmth + swelling + fever	Septic arthritis; osteomyelitis	Emergency evaluation; MRI; orthopedic surgery
Limp without clear injury	Legg-Calve-Perthes; slipped capital femoral epiphysis; hip pathology	Hip X-ray; pediatric orthopedics

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Pediatric Foot & Ankle Care at Balance Foot & Ankle

Children’s feet are not simply smaller versions of adult feet — they are still developing, and many conditions present differently in kids than in adults. At Balance Foot & Ankle, Dr. Biernacki provides experienced, compassionate care for children’s foot and ankle problems, from infants to teenagers. Early evaluation and treatment during growth years can prevent many adult foot problems from developing.

Flat Feet in Children

Flat feet are extremely common in young children — the arch typically develops by age 6–8. Most flat feet in children are flexible (the arch appears when the child stands on tiptoes) and require no treatment unless they cause pain or functional limitation. Painful flat feet, rigid flat feet (tarsal coalition), or flat feet that are causing excessive leg fatigue or gait problems benefit from custom orthotics and physical therapy. Dr. Biernacki performs a thorough evaluation to distinguish normal developmental flat feet from conditions requiring intervention.

In-Toeing and Out-Toeing

Many parents are concerned when their child walks with toes pointed inward (in-toeing) or outward (out-toeing). In-toeing in young children typically stems from internal tibial torsion or metatarsus adductus and usually resolves spontaneously by age 8–10. Out-toeing can result from external tibial torsion or femoral retroversion. The vast majority of gait variations in children are developmental and self-correcting. However, persistent, worsening, or painful gait abnormalities warrant evaluation. In rare cases, shoe modifications, orthotics, or referral to pediatric orthopedics is appropriate.

Sever’s Disease (Heel Pain in Active Children)

Sever’s disease is the most common cause of heel pain in children aged 8–14, particularly active kids involved in running and jumping sports. It’s caused by inflammation at the calcaneal growth plate where the Achilles tendon attaches, resulting from the pull of the growing Achilles on the incompletely developed growth plate. Treatment includes activity modification, heel cup inserts, stretching of the calf muscles, and sometimes a brief period of immobilization. Most children recover fully and can return to full sports participation. It does not cause long-term damage.

Plantar Warts in Children

Plantar warts (verruca plantaris) are caused by human papillomavirus (HPV) and are common in school-age children who spend time barefoot in communal areas like pools and gyms. They appear as rough, callus-like growths on the sole of the foot, often with black dots (thrombosed capillaries) visible. Treatment options include topical salicylic acid, cryotherapy (freezing), cantharidin application, laser therapy, and surgical excision for stubborn warts. Most warts in healthy children eventually resolve spontaneously, but treatment speeds resolution and reduces spread.

Ingrown Toenails in Children and Teenagers

Ingrown toenails are very common in teenagers and can become quite painful if infected. Dr. Biernacki performs gentle, effective in-office nail procedures including partial nail avulsion (removal of the ingrown border) with or without chemical matrixectomy (preventing permanent regrowth of the problem nail edge). Parents are often surprised at how quickly and comfortably this procedure can be performed, and how dramatically it improves their child’s quality of life.

When Should Your Child See a Podiatrist?

Bring your child to see Dr. Biernacki if they complain of recurring foot or heel pain, limp or avoid physical activity due to foot discomfort, have a gait that you notice worsening rather than improving, have warts, ingrown toenails, or nail infections, or you observe a structural abnormality in their feet. Early evaluation leads to simple, effective treatment — and healthier feet for life.

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In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your childrens foot ankle problems pediatric podiatry michigan, our podiatry team at Balance Foot & Ankle can help with expert evaluations and advanced in-office care.

Seen at both offices — Howell and Bloomfield Township.