Dr Hive: dd’s sore/painful feet

[sangtarah]

Please help me brainstorm what could be contributing to dd’s sore and painful feet.

 

Wednesday evening dd8 had her 3rd ballet lesson. Thursday her left foot was too sore to walk on. She has had lots of problems with this foot, beginning two years ago when her sister collapsed on it. She has re-injured it by dancing around the house several times.

 

Friday both feet hurt terribly. And over the weekend she has times of hardly walking. She’s in a lot of pain and sometimes grits through it. It seems to be concentrated to the bottom of her foot, where she flexes at. So if she flexes it hurts, when she walks it hurts. It is very very tender to the touch.

 

I have a few ideas to explore: structural problems (high arches?) arthritis (she has an autoimmune disease already), or just tender/prone to injury ligaments. Any other ideas for me?

 

We went to the dr today to see if they could help. So frustrating! We saw an NP who couldn’t do anything - couldn’t give referrals, or strategies, just “take Motrin and call me in the morning†and “talk to her PCMâ€.

 

 

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[displace]

I'd see either a pediatrician or a podiatrist.

 

But, it's possible it's sore from ballet exercises? And old injuries can pop up at a moment's notice. Maybe easy stretching can help?

[lmrich]

Does icing help? 

I would see a podiatrist. 

[Rebel Yell]

Is she new to ballet?

 

And find a way to go directly to a foot/ankle specialist. With two dancers and a martial artist we have one on speed dial

[trulycrabby]

She needs to see a podiatrist or foot/ankle orthopedist.

 

A child her age should bounce right back after injury or post-exercise soreness. With her autoimmune issue, you might consider having her see a rheumatologist if her foot problems don't improve.

[happi duck]

Sometimes muscle knots in calves and shins can caused referred pain in the feet.

 

No dance experience here but when we were looking into this I stumbled upon dancers talking about this.

 

One dancer had a video showing how to use an item called The Stick to roll out her legs. Runners also use The Stick.

[sangtarah]

All of our referrals have to go through a Primary Care Manager. So I’ll have to get into an appointment, and hope s/he agrees and lets us explore other options.

 

Nothing gives her long term relief. Icing does help some at the time.

 

She has done ballet before, but entry level classes and it was a couple years ago.

Edited October 2, 2017 by sangtarah

[Storygirl]

She could be over stressing them with the ballet. How many days a week is she dancing? If it started when she started lessons, I would think the two are linked.

 

It may be that she has an injury, or it may be that her autoimmune issues are making it more difficult to recover from the new movements her feet are doing. My daughters have both danced ballet. DD15 is an advanced ballet dancer; she says feet may be tired after class but should not hurt. DD12 used to take ballet around your daughter's age. She says her feet would sometimes feel a little tired and sore after class, but she never complained to me, so any discomfort was temporary.

 

In addition to talking to a doctor, talk to the ballet teacher. They should be alerted to the problem.

[Storygirl]

By the way, I am totally assuming that she is not dancing on pointe. Because there is no way she should be at that age, and a reputable teacher would not put kids that age on pointe.

 

[sangtarah]

She’s dancing 1 time per week for 45 minutes to an hour. She’s only a beginner, so no crazy moves, no pointe.

 

I will let her teacher know; she may have ideas for us, too.

[Pen]

plantar fasciitis??? bone spurs????  I agree she needs to see someone.

 

And ballet can be really rough on body.  A ballet dancer friend of mine needed a hip replacement in her 30's.  Had constant foot issues including bone spurs.

 

 

[Pen]

could even be a fracture...  maybe an ER or urgi-care could get around the PCM issue?

[StephanieZ]

I would take her to a better doctor. I'd also see a physical therapist that has special interest in feet. (Feet are really complicated, so often times, a particularly PT focuses on feet and will be more competent than a generalist.)

 

If your insurance permits, PTs can often be the primary diagnostician with these sorts of things. Our PT has been the primary diagnostician and treatment provider for all muscular/skeletal issues for our family once we found a great one. Unless it's broken/surgical, then the PT is generally MUCH MUCH more capable with these sorts of issues IME. A podiatrist would presumably also be an excellent way to go, but I don't have any experience with them. A regular general practice DR isn't who I'd rely on for this sort of thing (although a first go isn't a bad idea, but you've already tried that). I certainly wouldn't rely on a NP for this sort of thing. 

 

I wouldn't take her to ballet or have her do any other feet-intensive activities until a DR and PT have both checked her out and have given you a good plan of action. So, I'd find a podiatrist, a good PT, make appointments ASAP, and then carry on. While waiting for appointments, I'd try ice/rest/wearing comfortable shoes (comfy tennis shoes, most likely) at all times, and NSAIDs (unless contraindicated by other medical conditions). 

[Pen]

Just saw pics. Does she have bruising under her toe nails?

[Rachel]

My first thought was plantar fasciitis, it is incredibly painful. Her toes looked bruised though, or is that nail polish?

[Okra]

Definitely a foot Dr.

 

At 8 years old, she should not be in pain like this. 8 year olds tend to bounce back really quickly.

 

My son had odd foot pain and he was diagnosed with a rare foot problem that needed surgery.

 

We are so glad we went to a specialist that was able to help.

[sangtarah]

She had some toenail polish that was in its last stages. 😆

 

I am calling our clinic back tomorrow and will try to be nice, but I am seething about the appointment today. I just can’t believe how the NP saw this crying child and couldn’t offer anything but Motrin. If she didn’t have the ability to refer us, why did we see her? Such a waste of a day!! Ugh.

[sangtarah]

We saw Primary Care today....initial diagnosis of particularly bad plantar fasciitis. Very unusual for age 8. :sad:  X-rays and bloodwork were done, which hopefully will be normal. And physical therapy will be the treatment plan, but we probably won't be able to get into one until next week. Why can't things move faster! If the NP we had seen on Monday would've put in the referral, we could have had a PT appointment already!  :banghead:

 

Oh, and no dancing for at least 4-6 weeks.  :crying:

 

:bigear: I need some recommendations for really cushy footwear for a size 3, please!!  :bigear: 

[Guest]

I don't have a suggestion for shoes per se, but no flip flops!! Get supportive slippers if you can, mine even have arch support! Poor thing.

[almondbutterandjelly]

Crocs.  Or go to Fleet Feet and have them figure out sneakers and inserts for her.

[GailV]

 Ehlers-Danlos, or some other problems with connective tissue? 

 

We have a friend who dearly wants to take dance but can't due to Ehlers-Danlos.  It's not an autoimmune disease; I think there are autoimmune diseases that attack the connective tissues, though.

[itsheresomewhere]

We saw Primary Care today....initial diagnosis of particularly bad plantar fasciitis. Very unusual for age 8. :sad: X-rays and bloodwork were done, which hopefully will be normal. And physical therapy will be the treatment plan, but we probably won't be able to get into one until next week. Why can't things move faster! If the NP we had seen on Monday would've put in the referral, we could have had a PT appointment already! :banghead:

 

Oh, and no dancing for at least 4-6 weeks. :crying:

 

:bigear: I need some recommendations for really cushy footwear for a size 3, please!! :bigear:

I highly recommend consulting a foot specialist especially at her age. PF may not really be be the actual problem but a primary care would diagnosis it as such because it looks like it. Just my experience but really go for a 2nd opinion from a foot specialist.

 

Make sure that it is a pediatric PT not a regular PT. For me, asics ( with gel) are great along with fit flops or keens. For DD who has a foot issue, asics are her favorites along with her keens.

Edited October 4, 2017 by itsheresomewhere

[Guinevere]

I had a lot of foot trouble, including pf when I ran track, and I also had the best luck with Asics.

 

There are a lot of exercises on YouTube also.

[happi duck]

(hugs)

 

That is super painful, sorry she's going through this.

 

She may have muscle knots alongside her shin and in her calf that are contributing to this. It can hurt to work them out but it helps a lot.

[East Coast Sue]

My dd was diagnosed with plantar fasciitis following a fracture in her leg at the age of 5. Crocs or tennis shoes with inserts (firm heel lift) every time she stands/walks. Ice and stretching. We didn't see a PT. My dd was much improved very quickly, within a few days.

 

 

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[Rachel]

PT helped my plantar fasciitis immensely! Make sure she does all the stretches she is assigned.

 

I'd recommend good running shoes. In kid sizes I would look for Bew Balance, Saucony, or Brooks. Under Armor, Asics, and Nike make good supportive kid shoes too, but I find them more difficult to find the supportive styles.

[Chelle in MO]

That sounds miserable for her!  I had PF several years ago and my chiropractor did PT on me and recommended stretches/exercises on www.heelthatpain.com (look under the Home Remedies tab).  Maybe you could help her do some of those gently until you can see someone else. 

 

Best wishes for speedy healing!