Achilles tendon tightness is very common in growing kids and, sometimes, the most powerful deforming force at causing pes planovalgus deformity (flatfoot). In fast growing kids, the tendons have to play catch up with the bones. As the bones grow longer the tendons that span the joints have to expand in length also. And sometimes they achieve such length at a slower rate. This is the reason we often hear the term “growing pain”. Because of the attachment position of the Achilles tendon to the calcaneus (the heel bone), it tends to pull the bone to a lateral position and, doing so, brings the foot arch to the floor. Physical therapy can sometimes help, but cannot replace the value of daily home stretching. It is also important that coaches emphasize stretching before and after practices.
Sometimes, the Achilles tendon fails to catch up with the bone length. This causes the foot to adopt a flat position, which can be detrimental to the joints in the foot. In that case, surgery can be helpful.
The decision to bring a child to surgery for Achilles lengthening should not be taken lightly. It should be decided based on the degree of the deformity. The degree should be measured.
Any kid complaining of foot pain or tight Achilles should be seen by a specialist. And as parent, if you think your child has flatfoot, you should bring the child to see a doctor with experience in treating pediatric foot and ankle deformity.
Job Timeny, DPM
in Limb Lengthening and Limb deformity Correction
Foot and Ankle Surgeon
Fort Myers, Florida