parents know that children take to sports like ducks to water.
Almost as soon as they start to walk, they're chasing balls,
swinging sticks, and running races against nobody in particular.
sports used to mean baseball, basketball, or football. That's
changed. Soccer has leapt onto the youth sports scene, as
have wrestling, tennis, and lacrosse with older children.
The starting age for training in individual sports such as
swimming, skating, track, and gymnastics grows younger every
should encourage their children to participate in sports,
but never forget that competition should be fun. Too much
emphasis on winning can alienate a child from athletic competition.
active in sports programs will improve their cardiovascular
and musculoskeletal systems, coordination, and state of mind.
Participation in sports develops a sense of self discipline,
teamwork, and recognition of the importance of a healthy body
-- good habits that last a lifetime.
child physically matures at his or her own rate, and has a
different degree of athletic ability. No amount of training
can improve a child's natural athletic ability, but training
helps improve coordination, and therefore performance.
training should emphasize proper technique and basic movement
skills in all sports, especially in children younger than
10. Podiatric physicians, specialists in treating the lower
extremities, say children who concentrate on a single sport
at too young an age are more likely to develop injuries of
the foot and ankle. Save specialization in sports for the
late teens, they advise.
up before participating in sports is more important for adults
than children, but it helps loosen the muscles and prevent
injuries in athletes of all ages. Light jogging and smooth
stretching exercises (be sure not to bounce when stretching)
are all that's necessary for young athletes. Learning to stretch
at an early age will set a good pattern for sports activities
as the body develops.
parents like it or not, part of a child's image revolves around
footwear. Expensive sneakers have become fashion statements
as much as athletic equipment. But for good foot health, the
condition of the shoe is more important than the price tag
or brand name.
physicians agree it's often better to buy a child two $50
pairs of shoes than a single $100 pair, so the shoes can be
rotated, to avoid rapid wear deterioration. Excessive wearing
of the outsole, loss of shoe counter support, or wearing out
in the midsole indicate it's time to replace the shoes.
a child's feet are constantly growing, it is important to
allow at least one finger's width from the end of the longest
toe when buying shoes. Remember, proper fit is very important.
You can have the best shoe in the world, but if it doesn't
fit right, it doesn't do its job.
the shoe store, children should put on both shoes, with their
athletic socks and the laces tied tight, for several minutes
to properly check the shoes' fit. Shop for shoes in the afternoon,
when the feet are naturally slightly swollen.
young children, an "all purpose" sports shoe works well for
most sports. A running-specific shoe is not suitable as an
all purpose shoe; moving laterally in a running shoe is more
difficult and presents greater risk of injury for children.
After the age of 10, sport-specific shoes can help improve
performance and protect the feet. With the exception of the
running shoe, a degree of crossover between sporting shoes
is usually not harmful to the feet of a child athlete.
cleats are not usually necessary for children under 10, though
they pose little potential harm for them. They are most useful
on a soft-field sport such as soccer. Podiatric physicians
recommend molded shoe rubber cleats rather than the screw-on
variety. Metal baseball spikes can be dangerous and should
not be used until the teenage years.
Bones and Ligaments
immature bones of children are different from those of adults.
The "growth plates" in children's bones do not finish closing
until age 15-17 in boys and 13-15 in girls. When stressed,
these plates are more susceptible to injury than the tendons
and ligaments that support the joints. Ligaments tend to "give"
before bones in adults.
physicians warn repetitive overuse can cause inflammation
of the growth plates. They advise parents to promote diverse
physical activities for their children rather than one sport.
This is especially important with individual sports such as
running, gymnastics, and tennis, which require long hours
show children who concentrate on just one sport for long hours
at a time are setting themselves up for injuries. Because
of the susceptibility of bones with open growth centers to
overuse injuries, sponsors of the Boston Marathon recently
increased the minimum age to participate from 16 to 18.
sports medicine podiatrist can offer a thorough examination
of the entire lower extremity, and identify a leg length imbalance,
weakness, or biomechanical imbalances that may need to be
addressed to prevent injuries on the athletic field.
children suffer from mild "torsional" imbalances, commonly
known as in-toeing and out-toeing. Most children outgrow these
imbalances without medical treatment. However, if a child
has obvious torsional imbalances, he or she may be more susceptible
to injury. If that is the case, keep a close eye out for foot
and ankle injuries associated with sports activity. Foot injuries
commonly seen in very active children include:
Sprains. In older children, stretched or torn ligaments
in the ankle, known as sprains, are more common than fractures.
A sprain may cause extensive swelling around the ankle just
like a fracture. Immediate treatment is crucial to quick healing.
A podiatric physician can provide treatment as well as recommend
balancing and strengthening exercises to restore coordination
Fractures from overuse in child-athletes are commonly seen
in podiatric medical offices. Growth plates are particularly
susceptible to injuries, but mid-shaft fractures of the bone
also occur. If a fracture is not severe, rest and immobilization
may be the best treatment. More complicated injuries may require
casting or surgical correction. If swelling and pain persist,
see a podiatric physician.
Disease. An inflammation of a growth plate, Sever's Disease
is often felt as pain behind the heel caused by inflammation
of the apophysis, a growth center where a tendon is attached
to the bone. Rest, ice, and heel lifts are usually prescribed.
splints and stress fractures. Shin splints are microtears
or inflammation of the anterior leg muscles, as are Achilles
tendon pulls in the posterior region of the leg. Again, rest
is most important in healing these injuries. If pain is persistent,
see a podiatrist, who can recommend strengthening exercises,
certain shoes, or, if indicated, prescribe custom-made shoe
inserts known as orthoses.
Word to Parents
parents want to see their children do well in sports. But
putting too much pressure on a child to become a star athlete
may result in both physical and emotional injury to the child.
A child should enjoy playing a sport, but if forced, could
be turned away from all sports for a lifetime.
with individual sports such as swimming, figure skating, and
gymnastics that require long hours of practice every day,
be certain the child's heart is in the endeavor, not just
yours. When it comes to sports, overzealous parents can potentially
do their children more harm than good.
American Podiatric Medical Association operates a toll-free
telephone service, 1-800-FOOTCARE (1-800-366-8227),
from which consumers can obtain informative literature on
a variety of foot health topics. The American Academy of Podiatric
Sports Medicine, an affiliate of APMA, may be reached at 1-800-438-3355.
in cooperation with the American Academy of Podiatric Sports