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Dear Doctor

February 2017


I have a nine year old boy who adopts a limp only after being at school all day or after physical activity. He has now started to walk on his toes without realizing to alleviate the pain. We have been having physical therapy for four months, but they won't X-ray. The therapy is not working and this has been going on for seven months now. Any ideas? It is the sole of his feet and ankles that he complains is hurting.

- Debbie - UK (Parent)


The origin of a limp can come from any location in the leg. A pediatric orthopaedic surgeon is the best person to fully evaluate your child to make sure there is nothing serious happening. This will include a good exam of the entire lower body and possibly X-rays of specific parts of the body. Many times the X-rays are normal (as they only show bone conditions and don't evaluate ligaments and tendons well) and aren't ordered unless the exam is suspicious for a bony problem. Some children can have foot pain where the tendons and ligaments attach to bony growth plates, which is called apophysitis. Other children can develop stress fractures from overuse. Your orthopaedic surgeon will be able to fully evaluate for these conditions. Good luck!

- Debbie - UK (Parent)