Foot and ankle problems in children often go unnoticed. Signs and symptoms can be subtle, and sometimes children cannot explain what is wrong. But it is important to protect growing feet and to have problems checked out early.

The American College of Foot and Ankle Surgeons offers five warning signs parents should watch for.

1. Your Kids Cannot Keep Up with Their Peers. If children lag behind in sports or backyard play, it may be because their feet or legs are tired. Fatigue is common when children have flat feet. The muscles in the feet and legs tire easily because the feet are not functioning as well as they should. 
    
2. Children Voluntarily Withdraw from Activities They Usually Enjoy. If they are reluctant to participate, it may be due to heel pain—a problem often seen in children between the ages of eight and 14. Repetitive stress from sports may cause muscle strain and inflammation of the growth plate, a weak area at the back of a child’s heel.
    
3. They Do Not Want to Show You Their Feet. Children may feel pain or notice a change in the appearance of their feet or nails but do not tell their parents because they fear a trip to the doctor’s office. Surgeons encourage parents to make a habit of inspecting their child’s feet starting at a young age. Look for any changes, such as calluses, growths, skin discoloration or redness and swelling around the toenails.
    
4. Your Child Often Trips and Falls. Repeated clumsiness may be a sign of in-toeing, balance problems or neuromuscular conditions.
    
5. The Child Complains of Pain. It is never normal for a child to have foot pain. Injuries may seem minor, but if pain or swelling last more than a few days, have your child’s foot examined.
    

A child with any of these signs or symptoms should be promptly examined by a foot and ankle surgeon for proper diagnosis and treatment.

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