If your children are like mine, they like to watch television, play video or computer games, searching the internet and often even spend time listening to iPods or watching videos. This time has been nicknamed "screen time", because it limits the activity level of the child as they look at a "screen". Many people wonder if this excessive time can lead to problems. Studies have shown that as "screen time" increases, so does the childs weight. Childhood obesity has become more of a problem and can lead to many health problems including heart disease, blood pressure problems, diabetes and many others. In fact, childhood obesity has even been related to foot or leg pain.
According to a study in Pediatrics, published in the April 2010 issue, obese children have more leg, foot, and ankle injuries than similarly aged children of a healthy weight. The study, after measuring 23,000 children ages 3 to 14 years old, found that the one in six of whom were considered obese had significantly higher risk of injury to the foot or ankle. This was even taking into account the increased activity level (even in high risk sports) of the healthy weight children.
With this understanding, and the significant risk of systemic health problems, I have continued to encourage my children to remain active. We involve them in more sports, encourage them to spend time outside and even limit the time television or computers can be on during the day. As we facilitate this increased activity, and continue to be careful about the childhood eating habits, the risks of childhood obesity is decreased as is the associated risk for foot pain and foot or ankle injury.
I guess "screen time" really can cause foot pain! For more information, visit our Children's Foot page.
Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com
Monday, March 22, 2010
Monday, November 9, 2009
Does What You Eat In Pregnacy Help Your Child?
As the father of 10 children, we (although my wife has done all the work) have gone through just a couple pregnancies. Through each of these 10 pregnancies, my wife is always striving to make the best choices to have a healthy child. There is a new study that may help protect our children from diabetes even before they are born.
New evidence is emerging for how important it is for pregnant women to eat good, nutritious food. Expecting mothers who eat vegetables every day seem to have children who are less likely to develop Type 1 diabetes, according to a new study from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Full Story .
Although this is pre-birth information. It is worth considering what your child should be eating on a daily basis to preclude heart disease, circulation problems, diabetes and other systemic diseases. Many of these problems will present with foot & ankle concerns in my office over their lifetime.
Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com
New evidence is emerging for how important it is for pregnant women to eat good, nutritious food. Expecting mothers who eat vegetables every day seem to have children who are less likely to develop Type 1 diabetes, according to a new study from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Full Story .
Although this is pre-birth information. It is worth considering what your child should be eating on a daily basis to preclude heart disease, circulation problems, diabetes and other systemic diseases. Many of these problems will present with foot & ankle concerns in my office over their lifetime.
Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com
Tuesday, October 6, 2009
When Is Flat Feet A Problem In Kids?
On a regular basis, I have parents come with their children worried because of how they walk. They see flat feet in their children and worry if it is a problem that can cause other problems in the future. With this question ringing in my ear, I wanted to list several things that should be considered for flat feet in children.
1. Flat Feet is Normal in Infants. An infant has "baby fat" in the arch area and will present with flat feet. These feet will continue to change as the child grows and may develop an arch as the fat is resorbed over time. I have seen a lot of babies (even in my own home) and flat feet is expected.
2. Does Your Child Trip A Lot? Flat feet can be a normal variant, but if it leads to walking changes, like tripping and falling or turning in of feet it should be addressed.
3. Do They Have Pain In Legs or Feet? Pain to the feet is never normal. If the flat feet are a problem, the child will often present with aching to the feet, ankles or legs. They may not want to run and play or may ask to be carried on longer walks (if a younger child). Night pain to the legs may also indicate additional stress from flattening of the feet.
4. Abnormal Shoe Wear. Another indicator of possible problems is rapid wear of a shoe. Shoes should have normal wear on the outside of the back heel and inside of the toe. Too much wear on the inside of the heel, arch area or toe may indicate additional pressure. Depending on the shoe quality, the upper (cloth part of the shoe) may also rotate in (instead of staying over the sole of the shoe).
So if your child's foot is flat but has no pain, no tripping or falling and no abnormal wear of the shoes, it usually is not a problem. If any of these conditions present, it is recommended that the feet be evaluated by a foot & ankle specialist. We want to keep those little feet active, whether they are flat or not...
Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
http://www.utahfootdoc.com/
1. Flat Feet is Normal in Infants. An infant has "baby fat" in the arch area and will present with flat feet. These feet will continue to change as the child grows and may develop an arch as the fat is resorbed over time. I have seen a lot of babies (even in my own home) and flat feet is expected.
2. Does Your Child Trip A Lot? Flat feet can be a normal variant, but if it leads to walking changes, like tripping and falling or turning in of feet it should be addressed.
3. Do They Have Pain In Legs or Feet? Pain to the feet is never normal. If the flat feet are a problem, the child will often present with aching to the feet, ankles or legs. They may not want to run and play or may ask to be carried on longer walks (if a younger child). Night pain to the legs may also indicate additional stress from flattening of the feet.
4. Abnormal Shoe Wear. Another indicator of possible problems is rapid wear of a shoe. Shoes should have normal wear on the outside of the back heel and inside of the toe. Too much wear on the inside of the heel, arch area or toe may indicate additional pressure. Depending on the shoe quality, the upper (cloth part of the shoe) may also rotate in (instead of staying over the sole of the shoe).
So if your child's foot is flat but has no pain, no tripping or falling and no abnormal wear of the shoes, it usually is not a problem. If any of these conditions present, it is recommended that the feet be evaluated by a foot & ankle specialist. We want to keep those little feet active, whether they are flat or not...
Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
http://www.utahfootdoc.com/
Tuesday, September 22, 2009
How Do I Treat Burns On Feet?
In August 2009, a man was charged with injury to an 18 month old child after submersing the child's feet in a pot of boiling water. As the father of 10 children, it is unfathomable to me that an adult could act in such a way to a child. In fact, I hurt for that poor child that was unable to escape this attack. Although this act was purposeful, often children are injured by accidental scalding with water. Treatment depends on the type of burn, but here are some recommendations:
1st Degree Burn --> Seen as redness to the skin (often what we see with sunburn) and is painful. Treatments should include cooling the area, and protection. Cool water may help or a wet rag. Care should be utilized to not cause increased injury by covering with a cream that holds in the heat or applying ice to cause additional injury.
2nd Degree Burn --> A more advanced burn, consisting of redness with blisters or even white discoloration of skin. Treatments should include cooling the area, but keeping the blisters intact. Again cool water with dry, sterile gauze as a protection to the area should be utilized. Care should again be utilized to not apply creams or other ointments that could cause increased burning and increased pain. This type of burn should often be evaluated by a physician to ensure proper care is undertaken.
3rd Degree Burn --> This is a severe burn that can be emergent, especially in a child or infant. This can often be gray or black and may be painfree, as the nerve endings are destroyed (or burned). Treatment should be calling emergency services and getting help immediately to protect the child or infant. Don't remove clothing or pieces of clothing as this can cause increased damage to area. Any creams or ointments applied will need to be scrubbed off and will cause increased pain from the treatment.
Now with this basic information, the best treatment for a burn is prevention. Avoid burns and the associated pain and the child will be much happier than any treatment you or a physician could provide. Burns happen. Prevention and correct treatment can help limit their longterm effects on your children.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com
1st Degree Burn --> Seen as redness to the skin (often what we see with sunburn) and is painful. Treatments should include cooling the area, and protection. Cool water may help or a wet rag. Care should be utilized to not cause increased injury by covering with a cream that holds in the heat or applying ice to cause additional injury.
2nd Degree Burn --> A more advanced burn, consisting of redness with blisters or even white discoloration of skin. Treatments should include cooling the area, but keeping the blisters intact. Again cool water with dry, sterile gauze as a protection to the area should be utilized. Care should again be utilized to not apply creams or other ointments that could cause increased burning and increased pain. This type of burn should often be evaluated by a physician to ensure proper care is undertaken.
3rd Degree Burn --> This is a severe burn that can be emergent, especially in a child or infant. This can often be gray or black and may be painfree, as the nerve endings are destroyed (or burned). Treatment should be calling emergency services and getting help immediately to protect the child or infant. Don't remove clothing or pieces of clothing as this can cause increased damage to area. Any creams or ointments applied will need to be scrubbed off and will cause increased pain from the treatment.
Now with this basic information, the best treatment for a burn is prevention. Avoid burns and the associated pain and the child will be much happier than any treatment you or a physician could provide. Burns happen. Prevention and correct treatment can help limit their longterm effects on your children.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com
Monday, August 17, 2009
My Newborn's Feet
Two weeks ago, my wife and I had baby number 10 born into our home. A child always brings with it excitement, a great amount of joy, less sleep and new stresses. Most babies are cute and fun to hold. Most bring a different feeling into a home. But they also bring a greater responsibility and some worries. One concern that often comes to a new mom is the question: “Are there 10 fingers and toes?” To alleviate this worry, I have created a list of the 5 things to check on a newborn’s feet.
1. Most Babies Are Flat Footed. Approximately 97% of newborn feet are visually flat. This is due to the fat pad in the arch area from birth. Over time, this fat resorbs and the muscles and tendons produce the development of an arch. A flat footed baby should not be a concern. Just enjoy those cute, fat feet.
2. Flexible Feet. A newborn foot is and should be very flexible as bones are only partially developed and muscle, tendons and ligaments are still developing. A foot that is poorly positioned on the leg (tilted out or tilted in), not flexible (tight against the front of the leg) or even contorted (clubfoot) is a warning sign and should be evaluated by a foot and ankle specialist. Remember, thought, that sine the feet are soft and flexible, shoes should be purchased with the same features for a newborn foot (or even better allow them to be barefoot).
3. Baby Shape. The newborn foot shape is characteristically triangular in shape, consisting of a narrow heel and wide forefoot. The foot should be easily held between the thumb and forefinger in a “V” shape. This evaluation allows for evaluation of a foot that is “C” shaped, as the toes and forefoot area tilt in or out, instead of remaining straight. Due to the flexible nature of the infant foot, any abnormalities in shape may be modified by stretching and splinting if caught early.
4. Reflexes. In an infant, the common reflex tested is the Babinski sign. This is elicited by running a blunt instrument or finger from the bottom outside of the heel in a curve towards the big toe. The adult response is curving of toes down and turning the foot outward. In an infant, the response is spreading of the toes and elevation of the great toe. No response would be the only concerning finding at this time.
5. 10 Toes. This is commonly the first thing evaluated on the feet. Abnormalities may include toes that are abnormally large compared to other toes, too many toes, too few toes, or even absence of toes. Webbing of the toes may also be seen at this time. Treatment for many of these conditions is possible but may not always be necessary. Evaluation should be done through a specialized foot and ankle physician.
The foot is a very complex arrangement of bones, tendons, ligaments and vascular/nervous tissues. It will carry the new infant throughout life and should be protected. A key to the development of each foot is the ability to develop unimpeded by constricting clothes or shoes, as the foot with move quite regularly as muscle and tendons mature. Enjoy your babies feet, as they are part of the cuteness that is your baby.
Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com
Friday, April 3, 2009
My Active Child Has Foot Pain
As childhood obesity skyrockets, video game consoles seek for ways to make their games “active” and obesity related diseases such as diabetes is at epidemic levels, athletics is a blessing to many children. Since children are less likely today (compared to 20 years ago) to run outside, ride bikes or play sports in the streets, more children are becoming active in sports from soccer and football to gymnastics and dance. This increased activity has improved the health of many children, but sometimes is accompanied by heel or ankle pain.
When a child between the age of 9-14 in girls or 9-16 in boys presents to my office complaining of either heel pain or ankle pain, the cause is usually the same. The entity is commonly known as Severs Disease or Calcaneal Apophysitis. This is a disease of growing bone and therefore only presents in children during their stages of active growth. Let me explain some.
Every growing bone as a region called the physis that is cartilaginous tissue instead of calcified bone. As the bone grows, this allows expansion and calcification at the edges to help produce this growth. When full growth potential has been met, the calcification replaces the physis and creates healthy bone. This physis, however can be affected by pressure or tension and can become painful.
In calcaneal apophysitis, the growth plate of the heel bone (or calcaneus) receives tension during sports from the Achilles tendon (the strongest tendon in the body). This pressure causes increased stress, swelling and associated pain to the posterior heel area close to where the Achilles tendon attaches. The pain is caused by stretching of the physis or apophysis of the heel from a tight Achilles tendon during running. This pain can be problematic and significantly interfere with activities, and over the years has even stopped many from playing the sports they love. Although it resolves without treatment when the bone stops growing, often severe pain will limit activities for years. This is no longer the case. There are treatment options that can alleviate the pain and maintain the active lifestyle required to help our children remain healthy.
Calcaneal apophysitis or Severs Disease was once a disease of boys playing soccer. With the increased competition levels in all sports including dance and gymnastics, we are encountering this problem in boys and girls when they are active. So if your child is in the age range of 9 – 16 and complains of heel pain, especially when running or being active in sports, think calcaneal apophysitis. Get treatment from a foot and ankle specialist and help alleviate the pain associated with the exercise our children enjoy. Don’t make them stop their sport because of foot pain, help them resolve the pain while they await calcification of the growth plate and complete resolution of their symptoms.
Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com
When a child between the age of 9-14 in girls or 9-16 in boys presents to my office complaining of either heel pain or ankle pain, the cause is usually the same. The entity is commonly known as Severs Disease or Calcaneal Apophysitis. This is a disease of growing bone and therefore only presents in children during their stages of active growth. Let me explain some.
Every growing bone as a region called the physis that is cartilaginous tissue instead of calcified bone. As the bone grows, this allows expansion and calcification at the edges to help produce this growth. When full growth potential has been met, the calcification replaces the physis and creates healthy bone. This physis, however can be affected by pressure or tension and can become painful.
In calcaneal apophysitis, the growth plate of the heel bone (or calcaneus) receives tension during sports from the Achilles tendon (the strongest tendon in the body). This pressure causes increased stress, swelling and associated pain to the posterior heel area close to where the Achilles tendon attaches. The pain is caused by stretching of the physis or apophysis of the heel from a tight Achilles tendon during running. This pain can be problematic and significantly interfere with activities, and over the years has even stopped many from playing the sports they love. Although it resolves without treatment when the bone stops growing, often severe pain will limit activities for years. This is no longer the case. There are treatment options that can alleviate the pain and maintain the active lifestyle required to help our children remain healthy.
Calcaneal apophysitis or Severs Disease was once a disease of boys playing soccer. With the increased competition levels in all sports including dance and gymnastics, we are encountering this problem in boys and girls when they are active. So if your child is in the age range of 9 – 16 and complains of heel pain, especially when running or being active in sports, think calcaneal apophysitis. Get treatment from a foot and ankle specialist and help alleviate the pain associated with the exercise our children enjoy. Don’t make them stop their sport because of foot pain, help them resolve the pain while they await calcification of the growth plate and complete resolution of their symptoms.
Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com
Monday, February 23, 2009
Protect Your Child From Ingrown Toenails
On a regular basis, I see ingrown nails in both adults and children. Although the treatment is quite common, they can become a big problem and often can interfere in even normal activities and normal shoes.
Parents can help prevent this common and painful foot problem in children by following a few simple tips, and with a careful understanding of the common causes.
Ingrown toenails are primarily caused by an inherited tendency for the nails to curve, but may be aggravated by tight shoes, tight socks and incorrect nail trimming (nails should be trimmed straight across as opposed to curved like fingernails). In fact many people without an inherited tendency for nails to curve, will never have ingrowing even with tight shoes, poor nail trimming and other causative actions.
In my experience, many kids hide their painful toenails from their parents, even though the condition can cause significant pain. Over time, the nail may become increasingly red, swollen and painful and may even break the skin and lead to dangerous infections. Over the last year ACFAS (American College of Foot & Ankle Surgeons) has made some recommendations for minimizing this problem. Together with these recommendations, I will provide 10 ways to limit and/or prevent ingrown toenails in your children:
1. Nails should be regularly trimmed straight to minimize trauma to the nail during athletics or simple walking. A cracked or broken nail can often lead to ingrowing of the nail.
2. Rarely do we teach our children how to trim toenails (or fingernails for that matter). ACFAS recommends that parents teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don't cut them too short. I commonly trim my toenails straight and then remove the corners so there are no sharp edges.
3. Check your children's feet regularly (at least once or twice a week) to ensure they are caring for their nails properly. Don't wait until they are limping or hurting to check their toenails for infection or ingrowth.
4. When fitting your children for shoes, ensure that the fit are measured for both width and length. Regularly we fit shoes based only on length, but shoe width is just as important as length. ACFAS reminds us to make sure that the widest part of the shoe matches the widest part of your child's foot. This may mean that you are unable to pass shoes down from child to child.
5. Ensure children are wearing the proper shoes for the proper activity. Don't wear flip flops or go barefoot for athletic activities as injury to the nail and even the toe can occur.
6. Treat nail injuries aggressively to allow proper healing and limit ingrowth as the nail regrows.
7. If a child develops a painful ingrown toenail, parents can reduce the inflammation by soaking the child's foot in warm water (not hot) with epson salts. While in the water, the parent may also gently massaging the side of the nail fold to help remove any infectious drainage.
8. Antibiotics may often not be necessary if the ingrown nail is treated properly. A majority of the inflammation occurring is due to the nail being treated by the body as a "sliver". Once the nail is removed from the area, the inflammation improves. Soaking as mentioned above will then usually remove any remaining infection.
9. As confirmed by ACFAS, the only proper way to treat a child's ingrown toenail is with a minor surgical procedure at a doctor's office. Parents should never try to dig the nail out or cut it off. These dangerous "bathroom surgeries" carry a high risk for infection.
10. Notice if you see your child limping, the child has a red swollen toe, you see blood or drainage on a sock or you see a child start to cry with a simple "bump" of the toe. With any of these occurrences, you should be thinking ingrown toenail and seek to alleviate the infection and the pain by having it treated correctly.
Until that time, follow the above steps to limit the presentation and recurrence of an ingrown nail. Like you, we want to keep your children active, using these techniques can make it happen. Ingrown toenails although not life threatening can definitely interfere with life.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
Parents can help prevent this common and painful foot problem in children by following a few simple tips, and with a careful understanding of the common causes.
Ingrown toenails are primarily caused by an inherited tendency for the nails to curve, but may be aggravated by tight shoes, tight socks and incorrect nail trimming (nails should be trimmed straight across as opposed to curved like fingernails). In fact many people without an inherited tendency for nails to curve, will never have ingrowing even with tight shoes, poor nail trimming and other causative actions.
In my experience, many kids hide their painful toenails from their parents, even though the condition can cause significant pain. Over time, the nail may become increasingly red, swollen and painful and may even break the skin and lead to dangerous infections. Over the last year ACFAS (American College of Foot & Ankle Surgeons) has made some recommendations for minimizing this problem. Together with these recommendations, I will provide 10 ways to limit and/or prevent ingrown toenails in your children:
1. Nails should be regularly trimmed straight to minimize trauma to the nail during athletics or simple walking. A cracked or broken nail can often lead to ingrowing of the nail.
2. Rarely do we teach our children how to trim toenails (or fingernails for that matter). ACFAS recommends that parents teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don't cut them too short. I commonly trim my toenails straight and then remove the corners so there are no sharp edges.
3. Check your children's feet regularly (at least once or twice a week) to ensure they are caring for their nails properly. Don't wait until they are limping or hurting to check their toenails for infection or ingrowth.
4. When fitting your children for shoes, ensure that the fit are measured for both width and length. Regularly we fit shoes based only on length, but shoe width is just as important as length. ACFAS reminds us to make sure that the widest part of the shoe matches the widest part of your child's foot. This may mean that you are unable to pass shoes down from child to child.
5. Ensure children are wearing the proper shoes for the proper activity. Don't wear flip flops or go barefoot for athletic activities as injury to the nail and even the toe can occur.
6. Treat nail injuries aggressively to allow proper healing and limit ingrowth as the nail regrows.
7. If a child develops a painful ingrown toenail, parents can reduce the inflammation by soaking the child's foot in warm water (not hot) with epson salts. While in the water, the parent may also gently massaging the side of the nail fold to help remove any infectious drainage.
8. Antibiotics may often not be necessary if the ingrown nail is treated properly. A majority of the inflammation occurring is due to the nail being treated by the body as a "sliver". Once the nail is removed from the area, the inflammation improves. Soaking as mentioned above will then usually remove any remaining infection.
9. As confirmed by ACFAS, the only proper way to treat a child's ingrown toenail is with a minor surgical procedure at a doctor's office. Parents should never try to dig the nail out or cut it off. These dangerous "bathroom surgeries" carry a high risk for infection.
10. Notice if you see your child limping, the child has a red swollen toe, you see blood or drainage on a sock or you see a child start to cry with a simple "bump" of the toe. With any of these occurrences, you should be thinking ingrown toenail and seek to alleviate the infection and the pain by having it treated correctly.
Until that time, follow the above steps to limit the presentation and recurrence of an ingrown nail. Like you, we want to keep your children active, using these techniques can make it happen. Ingrown toenails although not life threatening can definitely interfere with life.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com
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