Brandon R. Gumbiner, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS), says he’s noticing more and more overweight and obese children with foot and ankle pain in his examining room, mirroring a national epidemic of childhood obesity.
An estimated 16 percent of U.S. children ages six to 19 are overweight, according to the Centers for Disease Control and Prevention. Poor diet, lack of exercise and genetics can play a role. A “vicious cycle’ of foot pain and obesity traps some children.
“You want overweight children to exercise and lose weight, but because of their weight, their feet hurt and they can’t exercise,” says Dr. Gumbiner, a foot and ankle surgeon in Seymour and Columbus, Indiana.
The foot is a complex structure consisting of 26 bones, 33 joints and more than 100 muscles, tendons and ligaments. Last November, researchers in Britain reported “alarming new evidence that childhood obesity changes foot structure and results in instability when walking.” Being overweight flattens the foot, straining the plantar
fascia, a band of tissue which runs from the heel to the
base of the toes, causing heel pain.
Because the heel bone is not fully developed until age
14 or older, overweight children are more prone to
Severs disease. Although not an actual disease, it involves
an inflammation of the heel’s growth plate due to muscle
strain and repetitive stress. Walking makes the pain worse.
Being overweight may also cause stress fractures, or hairline
fractures (breaks) in a child’s heel bone.
According to the ACFAS Web site FootHealthFacts.org, some overweight children suffer foot pain from congenital or inherited foot conditions, such as bunions, hammertoes, pediatric flatfoot and tarsal coalition, an abnormal connection between two or more bones in the back of the foot. Children with these deformities may be less active because of pain. Sometimes a child will complain of calf or arch pain. This results from a flatfoot that is flexible. The collapsing of the arch can require more energy, making it more difficult for a child to walk and run.
Foot and ankle surgeons treat many overweight children with custom orthotic devices (shoe inserts), physical therapy and other conservative measures to reduce or eliminate pain. But treating painful feet and ankles is only part of the childhood weight loss equation. When conservative measures fail, surgical treatment may need to be considered.
“As foot and ankle surgeons, we do our best to help reduce the aches and pains to keep children moving and playing. It is important to work as a team with parents, as they watch their children’s lifestyles and diets so that we may ensure success,” says Dr. Gumbiner.