Back-to-School Foot Pain: When Should Parents Be Concerned?

8 hours ago

6 min read

As children head back to school, their feet can suddenly be doing a lot more work.

Going from summer footwear to school shoes, walking around a larger school, standing for longer periods, PE, running at break time and returning to after-school sports can all mean a big adjustment for the feet after the summer holidays.

So what should you do if your child starts complaining that their feet, heels, ankles or legs hurt?

The good news is that many childhood aches are temporary and settle as children adjust to increased activity. However, persistent or recurring foot pain in children is worth paying attention to, particularly if it starts affecting how they walk, run or take part in activities they enjoy.

At BodyRight Physio, we regularly assess children with foot and lower-limb pain, sports injuries, balance and movement difficulties.

Why might my child have foot pain?

Children's feet are constantly developing. Their bones, muscles, tendons and joints are adapting as they grow, while they are also learning to run, jump, land and change direction.

There are lots of possible reasons for foot pain in kids, including:

A sudden increase in physical activity
New or poorly fitting school shoes
Increased sports participation
Minor strains or overuse
Tight muscles
Changes in walking or running mechanics
Foot or ankle alignment
Reduced strength or balance
An injury during sport or play

Sometimes the cause is straightforward. At other times, it isn't immediately obvious, which is where a paediatric physiotherapy assessment can be helpful.

Is foot pain just “growing pains”?

This is a common question from parents.

Children can certainly experience aches and pains as they grow, but not every pain should automatically be attributed to growing.

Typical growing pains tend to have a particular pattern and generally don't cause a child to limp or stop taking part in their normal activities. Sudden growth can mean the muscles need to catchup with the bones and can feel tight for a while, which can affect walking and running, kicking and posture. This is why muscle length tests are part of a paediatric physio assessment.

If your child's pain is persistent, consistently affecting one side, occurring during activity or changing the way they move, it is worth getting some advice rather than simply assuming they are growing.

What about heel pain in children?

Heel pain in kids is relatively common in active children, particularly around periods of rapid growth and increased sporting activity.

You may notice your child complaining of pain around the heel after running, jumping or playing sport. They may also start avoiding activities that involve running or jumping.

Sometimes reducing the intensity of activity temporarily and allowing adequate recovery is enough for symptoms to settle.

However, ongoing heel pain in a child should be assessed, particularly if it is interfering with sport, PE or everyday activities.

A paediatric physiotherapist can look at how your child walks, runs and moves, as well as their strength, flexibility, balance and foot and ankle function.

Could their school shoes be causing the problem?

Possibly.

The start of a new school year is often when children move into a new pair of shoes — and occasionally those shoes aren't quite the right fit.

When checking your child's school shoes, look for:

Enough room at the toes

Your child's toes should have enough space to move comfortably. They shouldn't be squashed together or pushed against the end of the shoe.

The right width

A shoe can be long enough but still too narrow. Look for signs of pressure, rubbing or redness after wearing them.

A secure fit

The shoe should stay comfortably on the foot without your child having to grip with their toes to keep it in place. A firm heel cup (back of the heel) helps provide support for good heel strike.

Comfort

Perhaps the most important point of all: your child should be comfortable in their shoes.

Children's feet don't all develop in exactly the same way, so there isn't one particular type of school shoe that is perfect for every child.

What if my child has flat feet?

Flat feet in kids are one of the most common things parents notice.

In many children, a relatively flat-looking foot is simply part of normal development and does not require treatment.

The important question isn't necessarily:

“Do my child's feet look flat?”

but rather:

“Are their feet causing them a problem?”

If your child has flat-looking feet but is comfortable, active and able to participate normally, there may be no reason for concern.

If they have persistent pain, fatigue, difficulty keeping up with their friends or problems with walking or running, an assessment can help determine whether their foot shape is relevant to their symptoms.

What about feet that turn in or out?

Parents often notice that their child's feet point inwards or outwards when they walk or run.

There are many normal variations in children's development, and the appearance of a child's feet doesn't necessarily tell us whether there is a problem.

Rather than trying to correct the position based on appearance alone, it's more useful to consider how your child is functioning.

Can they:

Walk comfortably?
Run and change direction?
Jump and land?
Take part in PE?
Play sport?
Keep up with their friends?
Do all of this without pain?

If the answer is yes, there may be nothing that needs correcting.

If there are difficulties with these activities, a paediatric physio assessment can help you understand what is happening.

When should I get my child's foot pain checked?

It's a good idea to seek advice if your child's pain:

Keeps coming back
Is getting worse
Causes them to limp
Changes the way they walk or run
Stops them participating in PE or sport
Is consistently affecting one foot or leg
Occurs regularly during or after activity
Is associated with swelling
Started following an injury and isn't settling
Is causing them to avoid activities they previously enjoyed

You don't need to wait until the problem becomes severe.

Sometimes an early assessment can simply identify what is causing the discomfort and provide advice on managing activity, footwear and recovery.

What can you do at home?

If your child has mild aches after returning to school and is otherwise moving normally, there are some simple things you can try.

Build activity back up gradually

If your child hasn't been very active over the summer, jumping straight back into PE, football,

GAA, dance or other sports can be a big change.

Where possible, increase activity gradually and allow time for recovery.

Check their shoes

Make sure school shoes and sports shoes still fit properly. Children's feet can change surprisingly quickly!

Encourage rest when they need it

Rest doesn't mean your child has to stop moving altogether. It simply means giving painful or tired areas a chance to recover.

Keep an eye on the pattern

Rather than just asking, “Does it still hurt?”, notice when your child's pain occurs.

Does it happen after running? At the end of the school day? In one particular shoe? During a particular sport?

These details can be really helpful when assessing the problem.

Does my child need orthotics?

Not necessarily.

Orthotics can be useful for some children, but they aren't automatically needed because a child has flat feet, in-toeing or a particular foot shape.

A good assessment should first establish whether there is a problem that needs addressing and what is contributing to it.

Depending on what we find, the best approach might simply be advice on footwear, activity levels, strengthening, balance or movement.

For some children, an orthotic may form part of their management plan. For others, it may offer no additional benefit.

The aim should always be to treat the child, not simply the appearance of their feet.

Back to school doesn't have to mean back to pain

A few aches and tired feet after the first busy weeks of school can be completely normal.

But if your child repeatedly complains of foot pain, heel pain, ankle pain or leg pain, is limping, struggling with sport or changing the way they move, it's worth finding out why.

At Bodyright Physio in Drogheda, Louth, our paediatric physiotherapists look at the whole child — including their strength, balance, walking, running, footwear, activity levels and the things that are important to them.

Sometimes the answer is simple reassurance. Sometimes a few practical changes can make a big difference. And when further treatment is needed, we can work with you and your child to develop an appropriate plan.

If you're looking for paediatric physiotherapy in Drogheda and are concerned about your child's feet, walking, running or sports participation, we're happy to help.

If your child's feet are stopping them doing the things they love, don't just put it down to growing. Let's take a look.