This relates mainly to the very active child and the early secondary school years. Many very young children will attend playgroups and nursery where they will have a more formal exercise routine and may also take part in climbing. They rarely approach podiatrists with problems associated with exercise, but may be referred to a podiatrist due to concern about the way a child walks or unusual wear marks on shoes, such as on the inside or outside of the heel.

During the primary school years they will become more active: dance, gymnastics classes and occasionally martial arts classes are undertaken. Once again, there may be problems associated with injury but overuse begins to become a feature. Foot arch pain is not uncommon, particularly in children who have very low arches or are double jointed. They may awaken their parents during the night with distressing pains in their legs and feet. Often no organic cause is found for this problem but children with a postural foot problem often improve when treated with foot orthoses (insoles). The incidence and severity of pain is usually associated with the level of activity. If no improvement takes place in the short term, it is always advisable to investigate the problem further.

In late primary school and secondary school, growth begins to accelerate and the child reaches puberty. At the same time, sporting and athletic activities tend to increase and become more formalised. The child will also be more active during the school day and may travel further to school. There may also be activities in the evening for a particular interest or talent. This can result in foot and lower limb problems associated with excessive unaccustomed exercise. Growth, possible weight gain and increased exercise contrive to cause a wide range of painful foot and lower limb problems that may be sports related. These complaints should always be taken seriously and a diagnosis made. Failure to recognise and treat these overuse problems can lead to long-term problems for the child and an inability to reach their true sporting potential. Most problems are readily managed by your podiatrist, utilising a variety of methods. But the treatment may also require periods of rest and a change to everyday footwear and activity footwear. Often the problem is easily solved with footwear advice alone. Always remember to wear the correct footwear for the individual sport. You wouldn’t play squash in stiletto heels or tennis in football boots. Equally, different types of trainers are required for different sports.

Bare footed activities, e.g. karate, judo, while good exercise for the foot can result in injury but also cause problems due to the foot having a relatively lower heel from what it is used to during the day as shoes are not being worn. This puts added strain on the arch of the foot and back of the lower leg. Careful training and preparation are essential.

If a child indulges in any form of activity, injuries will occur and there will be aches and pains from time to time. Children are no different from adults in this respect but they tend to repair more quickly. Also, they will not rest due to an injury and need to be managed and monitored carefully. Very young children may regard the problem as the norm and not complain. All aches and pains in children should be taken seriously and investigated professionally, particularly during periods of active growth.