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9 year old child has a sore ankle/leg. What can I do to help?(52 Posts)
DD has had some trouble with her legs and feet for a little while. She has quite a prominent in-step on both feet, always has, it has been worse/better over the years at various stages, but never caused her pain, discomfort or affected her walking/running etc. Told as a young child by medical professionals to keep an eye as she grows but likely will grow out of it and also if it doesn't cause her problems it probably won't be addressed in any way.
Over the last few months, she has complained that her knees knock when she runs, and when playing some sports such as hockey her ankles have been hurting, more in her right leg/ankle. Also that her thighs hurt a little.
It's got worse over the last months, to the point that now when she walks, her feet turn very inwards (right in particular) after a while, and she can turn both ankles/feet completely the other way. After walking quite short distances she is in some pain and is starting to not want to do activities that require walking/running/moving.
Saw GP (locum) a couple of months ago who said it was perfectly normal and nothing to worry about. As it got worse, I took her back a couple of weeks ago, especially after she showed me how she could turn her feet backwards on themselves. GP has referred to physic for an assessment, but says he thinks its probably just that she has had a growth spurt and that her muscles/ligaments haven't caught up yet, so pulling her feet in slightly, and causing it to hurt. He said physio will check to see where the instep comes from (i.e., hips, knees or ankle themselves) and likely give her physio exercises to strengthen muscles/ligaments if it's what he thinks is the case.
He doesn't think it's joint hyper mobility syndrome as she can't bend her thumb backwards and has no hyper mobile joints anywhere else that we can tell.
She is off school today as her right ankle and lower leg is so painful she can't bear weight on it. It has been steadily building over the last few days, and by last night she was crying in pain, woke in the night with pain (not usual) and sobbed at the prospect of going to school (not usual for her either). It hurts to bear weight, but also to turn the ankle and move it - it hurts around the ankle and up the leg on the lower part of her lower limb. Her left leg hurts a little but nowhere near as bad as right leg.
Called physio today, they have a cancellation for tomorrow, and she is going in for that appt.
In the meantime, what can I do to help with the pain? She has been having calpol and ibuprofen alternating for the last few days, but by last night it didn't do a huge amount. Have used ice pack, which eased it a little.
Can I strap it? How would I do that? Anything else I can do to ease it for her? Didn't want to take her to docs today, as it's another locum who I saw myself this week and she was a bit useless to be honest so didn't see the point of taking her today.
Hopefully the physio will suggest referral to a specialist. Sounds unbearable.
I hope so, but suspect whatever treatment/diagnosis etc comes from tomorrow, it's not going to be quick. I had a little cry on her behalf this morning as she was in so much pain and I couldn't help it.
She is feeling a lot better now meds have kicked in, but still can't bear weight on it.
If she were mine and the GP had been so totally useless, I would take her to A&E right now while it's quiet and she's off school anyway. Something is badly wrong. She doesn't have to put up with this !
I am thinking that she may have strained something, or pulled something, while it's all clearly so tender.
I didn't think to take her to A&E. Won't I get looked at like a batshit mother? It's not swollen, definitely not broken, as the pain seems to be following a muscle/ligament type of pathway down the side of her leg.
With the greatest respect, it seems far more batshit to allow her to suffer the pain you're describing.
Touch the place that hurts, if it's hot at cold if it's cold add hot. If neither ice intermittently. Those microwave hot water bottles are good as you can freeze or heat them
Ibruprofen for pain. Elevate
You can strap if you know how but physio most likely won't approve. I'll be a little worried about home strapping as it doesn't seem a straight forward ankle injury
I would be tempted to take to a&e if only to xray and check for breaks.
As a side issue do check tomorrow whether insoles are appropriate. They do wonders but take an age to actually receive, especially if you need a separate referral to Podiatry (which is sometimes necessary). Also ask about what you should be looking for in shoes. The right shoes can also be very important.
Fwiw you can have extremely hypermobile joints and it not be every joint. So your thumb might not be hypermobile but your ankles might extremely.
Also bear in mind that hormones can impact on the mobility of joints.
And the hot and cold thing isn't a rule just a guideline. Try both.
Hi footle she is feeling much better, so haven't taken her to docs or A&E, as she has physio so soon, if it were a longer wait I would have, if it hadn't eased. She can stand on it now, gingerly, although it does hurt a lot still, so felt it didn't warrant A&E.
toffeelatte that's really useful to know, thank you. her leg/foot is probably more cold than not, and the opposite of swollen, it looks a little skinnier than her other leg/foot, seems a little like the muscles are not as prominent.
Interestingly, she has had, for a while, and worse lately, IBS type symptoms, which are managed with lots of vegetables, minimal bread and fatty food. But it flares up causing a lot of pain. I had read that IBS/gastro issues can be linked with hyper mobility issues, but thought that the doc was pretty certain it wasn't.
I don't know how to strap it, and so I have left it as I don't know what I am strapping anyway.
She has done much more walking recently, 5 mile walk for school, 5 mile walk with family, walk for trick or treating, and it's been since these walks that the pain has increased markedly. Maybe we have had her do too much walking.
I'll make sure I ask about orthotics. Appointment is in the morning, so if there is a suspected injury, we can deal with it then/after with physio guidance as we are in the same hospital as A&E etc.
Thanks both of you
and i've got both hot and cold packs coming out of my ears as I need them myself so she's ok on that front. Made sure she hasn't done anything requiring walking, other than to the loo, to the dinner table etc. And she has had it elevated, iced and I'll put some heat on too now.
I have this, or something similar. it affected me most at age 16-24 but started with episodes like you describe at around age 11. I have hypermobile ankles and knees which gives me knee and foot pain and well as sore hips and a bad back. I had countless mri scans, physio appts etc and ended up with painkillers and a referral to a podiatrist who made me some insoles which helped massively in keeping my feet straight. I used to get pain after work (at McDonalds so long hours standing) that would keep me awake and sobbing even with the insoles. I hope someone is more help to your DD than they were to me!
I'm now 30 and still have really bad days/nights but have learnt when to take it easy, painkillers and heat packs are my friend. I always found cold and ice made the pain much worse, only heat helped. Hope you get some answers from the physio!
It does sound far more like a hypermobile joints issue, but of course if it is you are more prone to injury anyway.
DD has a similar thing (also hyper mobile in major joints and not thumbs!) and our gp said it was Severs Disease. Which isn't a disease so much as a syndrome apparently,
Anyway, her legs are apparently growing faster than the Achilles' tendon and that is putting pressure on her heel plate. Rest and time we were told.
On the shoes front, we found Kickers kick high made a fantastic difference to DS and his hypermobile ankles + inturned foot. I'd love to get him in dr martens but he has stamina issues so the extra weight would not be great. I've spent a long time talking shoes with DS' physio.
If you have hyper mobile joints walking is a killer. It's always a payoff. You don't want to stop doing stuff because it is good for you but I can imagine that amount of walking over a few days would be sore. Physio generally don't like you to strap because they like the muscles not to get lazy however for many years if I knew I was going to be walking any distance I would strap my ankles either in a straight ankle support or with kinesiology tape. DS uses a wheelchair over any distance, his walking deteriorates rapidly if he overdoes it, in turned ankle/foot get significantly worse and he falls more.
Zombie: have you tried a decent private physio? The right one really can help enormously.
Thanks for the update, OP. It sounds so miserable for her, and not like an injury as she can turn both feet round. If that's not hyper mobility I don't know what is. I hope tomorrow brings some clarity to her situation.
toffee finding shoes is really, really difficult actually. She has long thin feet too, and none of them fit her properly really. When she was younger it was easier as most children's shoes are higher at the heel and padded/tighter fitting and have cushioned soles. Many school shoes for her age are much more fashion style, and clarks had none that would fit both thin and long, and also help with the instep - a few of those, especially those without any ankle support at all made her instep much worse, and pulls the foot onto it's inner side as well as making it turn in more.
I bought her a pair in the end from start-rite, cushioned, well padded around the ankles, doc martin mary jane style. They were £52! We realised then we need to be spending money on her shoes, and I am struggling to find any 'fun' shoes for her that fit, are comfy and provide some support for her ankles. She mostly wears trainers at the moment out of school, which is not great really as she wants pretty sometimes too.
Winter is better, as there is a better choice for boots I think, to provide a bit more support for her.
I will look at the kickers, she had them when she was very little and actually, thinking back, probably she walked best when she had those. They just make her feet look very big and clunky due to the length of her feet. (she is a 2.5-3 in length but around a 1 in width, with bony toes).
I was thinking about the doc martins, but good to know they are quite heavy, don't think they will help her right now, but I will make sure I talk shoes with the physio. She would love doc martins though! (she'd also be happy with Kickers, she really likes the silver or multi coloured ones!).
The instep getting worse/turning in more and falling over more that your DS finds toffee when he walks too much is exactly what happened to DD last time she walked too far. She kept stumbling (DH said, and also that her instep was much worse. And he never makes a fuss about things, even he was bothered. I wasn't there at the time) and when she got to me (I was drinking coffee by the river nearby as can't walk far due to back problem of my own) she cried and said she wasn't going on walks again.
zombie oh you poor thing that it still causes you problems this long after it first became a problem.
I have to admit, whatever it is (and it does sound hyermobile in nature, you are right footle it's not usual to be able to turn your feet completely around) I am worried for her. She is normally highly active, loves walking, climbing (not so much running), swimming, bike riding, skating (but not well! as she can't get her feet straight enough!) and wants to do ice skating. She asked to start cross country running (before this big pain spike) but I have asked her to wait until we get her feet sorted first.
I hope this doesn't stop her being active in the long term.
scones not heard of severs disease, will go check. How is your DD generally with it, does it interfere a lot in daily activities? how old is she?
I have EDS (hypermobility type) and had problems like your daughter's at her age. I also have hyper pronated ankles, knees and hips and can turn my ankles backwards. Unfortunately, mine got worse and worse and worse and now i'm a wheelchair user as my hips, knees and ankles can no longer support my weight. This wouldn't have happened (probably) if I had had support in childhood. If its is hypermobility (not all hypermobility is EDS-EDS has other implications like gastric and heart-but her IBS is a bit of a red flag, although some young girls struggle with hypermobility which improves after puberty) then she needs physio, proper ankle support through braces and orthotics and a decent painkiller regime. Try to keep her as active as possible, muscles support ligaments.
Pavlov, my DD is 12. Generally she is ok, but if we do lots of walking or standing around she does get sore.
Interestingly, she has the exact opposite kind of feet to your daughter! Small feet (she measures at 1.5) but feet so wide she has to substantially size up (currently wearing a 4) as she measures at over an h. She has worn startrite since she could walk.
Heart goes out to your DD. It's horrible when you lose faith in your own body.
I know what you mean on the cost of shoes to. For me it's a major reason for keeping amazon prime going. Kickers (DS) and Dr martens (DD who has also had some hopefully short term ankle issues) are a good price I can order several styles and send them all back for free if necessary. We don't have decent shoes shops near us so the cost of getting there stacks up, I can guarantee amazon have what I want in stock at the right price and get it delivered for the next day.
That said coincidently i have recently found out from the dr martens store that different dr martens apparently fit differently. Some are narrower and slimmer in the foot. If your DD is keen, i wouldnt rule out dr martens. Your DD is clearly very fit and when this hump is over the weight might not be a factor. Especially when you consider Dr Martens with pretty ribbon laces.
I know they say trainers are fine, but i watch DS walk in them (looking from behind) and he automatically roles the ankle/ heel inwards, leg is not directly over ankle where it is meant to be. Thankfully school have been fantastically sensible and with physio's blessing trainers are gone and DS wears kickers for everything including pe. We didnt bother with sandals this year. Kickers are fantastic for the price.
Some kangol shoes in sports direct actually pass muster on the cheap end of pretty girls school shoes (£20 and under)and are quite long and thin. (I am the nutter in the shop making sure the sole bends but not twists and has the right heel cup).
DS destroys clarks.
Still think boots would be better for your DD though, even for school.
Pavlov with regards to being active, I have represented my county in cross country and hockey and got my city colours for tennis. I have played hockey at various levels continuously for the last 19 years barring 2 seasons (both when pregnant). I also snowboard. I have strategies for managing the effects and sometimes these activities do cause pain but the enjoyment I get is worth it! Orthotics helped massively and I still buy astroturf boots for hockey based on how they fit my orthotics.
Toffee physio is on my list, ds is now 12mo so I'm starting to have the occasional minute to myself again! ??
unweaved I'm sorry to hear your EDS deteriorated so badly as you grew older
Zombie I am in awe of how you have done it all! I love the way you word it with regard to balancing the enjoyment and the pain.
zombie that's really positive to hear. She loves being active, and I would hate to see that disappear. Hopefully we will get the right support quickly to help her manage this well and enable her to continue doing things that she enjoys.
I want to wear Doc Martins with pretty ribbons myself toffee I have noticed that her feet roll a little in her trainers also, but also, they have good heel support so have gone with it. Probably they are not helping. I think I agree with boots.
I will go check on Amazon now for some, thanks for that tip. I have used it for my own boots, to help with my back problem (Fly London, fabulous for cushioned soles with a bit of style, maybe they will have some suitable for DD? <goes off to look>
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