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In-toeing and out-toeing are common foot and lower-limb alignment conditions that affect the way a child’s feet point while walking or standing. In-toeing occurs when the feet turn inward, while out-toeing occurs when the feet point outward. These conditions are often noticed when children begin walking and may change as the bones and muscles develop. Understanding the definition and causes of in-toeing and out-toeing can help parents recognize normal development patterns and identify when professional evaluation may be needed.

Signs of in-toeing include toes pointing inward, frequent tripping, or an uneven walking pattern. Out-toeing may appear as feet turning outward while walking, standing, or running. Some children may have difficulty with balance or coordination, although many cases improve naturally with growth. Risk factors include family history, differences in bone development, muscle tightness, and positioning during early growth. The alignment of the hips, knees, and feet can all influence how a child walks and moves.

The causes of in-toeing and out-toeing vary depending on the child’s stage of development. In-toeing may result from curved foot structure, inward rotation of the shin bone, or inward positioning of the thigh bone. Out-toeing may develop from outward rotation of the hip, leg alignment differences, or foot positioning issues. These conditions are not always caused by footwear or walking habits, but certain structural factors can influence how the feet align.

Early observation and regular monitoring can help ensure healthy foot development. Supportive footwear, proper movement habits, and professional guidance may be recommended depending on the severity of the condition. Most children improve as they grow, but some cases may require treatment to support proper alignment and function. If your child shows signs of in-toeing or out-toeing, it is suggested that you consult a podiatrist for effective treatment and management solutions. 

The health of a child’s feet is vital to their overall well-being. If you have any questions regarding foot health, contact Dr. Thomas Madden of Advanced Foot Care Center. Our doctor can provide the care you need to keep you pain-free and on your feet.

Tips for Keeping Children's Feet Healthy

• Make sure their shoes fit properly
• Look for any signs of in-toeing or out-toeing
• Check to see if they have Clubfoot (condition that affects your child’s foot and ankle, twisting the heel and toes inward) which is one of the most common nonmajor birth defects.
• Lightly cover your baby’s feet (Tight covers may keep your baby from moving their feet freely, and could prevent normal development)
• Allow your toddler to go shoeless (Shoes can be restricting for a young child’s foot)
• Cut toenails straight across to avoid ingrown toenails
• Keep your child’s foot clean and dry
• Cover cuts and scrapes. Wash any scratches with soap and water and cover them with a bandage until they’ve healed.

If you have any questions, please feel free to contact our office located in Killeen, TX . We offer the newest diagnostic and treatment technologies for all your foot care needs.

A broken ankle occurs when one or more bones around the ankle joint crack or break. An ankle can break after a fall, a sudden twist, or a forceful impact. The outer ankle bone, called the lateral malleolus, is the area most frequently affected. Symptoms include immediate pain, swelling, and bruising. Patients may also notice tenderness or difficulty placing weight on the injured foot. Numbness, cool skin, or a visible change in the ankle’s shape can signal a serious injury. In severe cases, a broken bone can push through the skin and require urgent medical attention.

Ankle fractures are described as stable or unstable. With a stable fracture, the broken pieces remain in their proper positions. Many breaks involving only the outer ankle are stable and do not require surgery. In an unstable fracture, the bone pieces shift and can disturb the joint’s normal alignment. A podiatrist examines the ankle and checks the foot for changes in sensation, temperature, and blood flow. X-rays reveal where the bone broke and whether the pieces have moved. Additional imaging can provide a closer view of a complicated break. It can also show any damage to the ligaments and tendons that support the ankle.

Treatment is based on the break’s location, alignment, and severity. A podiatrist can place a stable fracture in a cast or walking boot to protect the injured area. The podiatrist also gives clear instructions about when the patient can safely place weight on the foot. Follow-up X-rays track healing and confirm that the bones remain properly aligned. An unstable or open fracture can require surgery to restore alignment and secure the damaged bones. Regular examinations help identify poor healing, continued swelling, or joint changes that could cause arthritis. A podiatrist can also guide a safe return to work, exercise, and other daily activities. If you have broken your ankle, it is suggested that you schedule an appointment with a podiatrist for an accurate diagnosis and appropriate treatment.

Broken ankles need immediate treatment. If you are seeking treatment, contact Dr. Thomas Madden from Advanced Foot Care Center. Our doctor can provide the care you need to keep you pain-free and on your feet. 

Broken Ankles
A broken ankle is experienced when a person fractures their tibia or fibula in the lower leg and ankle area. Both of these bones are attached at the bottom of the leg and combine to form what we know to be our ankle.

When a physician is referring to a break of the ankle, he or she is usually referring to a break in the area where the tibia and fibula are joined to create our ankle joint. Ankles are more prone to fractures because the ankle is an area that suffers a lot of pressure and stress. There are some obvious signs when a person experiences a fractured ankle, and the following symptoms may be present.

Symptoms of a Fractured Ankle

• Excessive pain when the area is touched or when any pressure is placed on the ankle
• Swelling around the area
• Bruising of the area
• Area appears to be deformed

If you suspect an ankle fracture, it is recommended to seek treatment as soon as possible. The sooner you have your podiatrist diagnose the fracture, the quicker you’ll be on the way towards recovery.

If you have any questions, please feel free to contact our office located in Killeen, TX . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Sever’s disease is a painful heel condition that affects growing children, especially those who participate in running or jumping sports. It is not a disease in the usual sense but an irritation of the heel’s growth plate, which is the area where new bone is still forming. This growth plate sits at the back of the heel bone, near where the Achilles tendon attaches. When a child runs, jumps, or lands hard, repeated pulling and pressure can irritate this area. Soccer, basketball, gymnastics, and football can place extra stress on the heel.

Heel pain from Sever’s disease usually develops slowly. A child may describe the pain as feeling like a bruise at the back or bottom of the heel. The pain is usually worse with sports, running in cleats, or wearing shoes that lack adequate support. Swelling and bruising are not always seen. Some children limp, walk on their toes, or stop wanting to play. Tight calf muscles, flat feet, and high-arched feet can increase stress on the heel. A podiatrist can examine the heel, check the foot structure, and look at how the child walks.

Diagnosis does not rely on symptoms alone. A podiatrist can tell whether the pain is from Sever’s disease or another problem. X-rays can be ordered to check bone growth and rule out other causes of heel pain. A stress fracture, tendon irritation, or a bone cyst may produce similar symptoms. Treatment of Sever’s disease includes shoe changes, heel lifts, custom orthotics, and activity guidance based on the child’s exam. A podiatrist can also address tight calf muscles and foot mechanics that add strain to the heel. If your active child complains of heel pain, it is suggested that you schedule an appointment with a podiatrist for a diagnosis and effective relief tips.

Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see Dr. Thomas Madden from Advanced Foot Care Center. Our doctor can treat your child’s foot and ankle needs.

Sever’s Disease

Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.

Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.

Symptoms

Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.

Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their feet.

If you have any questions, please feel free to contact our office located in Killeen, TX . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Cracked heels develop when the skin around the heel becomes dry, thick, and less flexible. Some cracks remain shallow, while others become deeper and make daily activities uncomfortable.  As pressure is placed on the heel during standing and walking, the skin may split, creating painful cracks known as fissures. Common symptoms of cracked heels include dry skin, rough patches, and heel pain. In more severe cases, the cracks may bleed or become irritated. People who spend long periods standing or have certain medical conditions may have a greater risk of developing cracked heels. Because untreated cracks can worsen, a professional evaluation is important to determine the severity of the condition and recommend appropriate treatment.

Cracked heels can affect more than comfort. Deep fissures may make walking painful and increase the risk of infection if the skin barrier is damaged. Ongoing heel pain may also change the way a person walks, placing extra stress on the ankles, knees, and hips. This altered movement can contribute to discomfort in other parts of the lower body. A thorough podiatry evaluation helps identify the underlying cause of cracked heels and determine whether additional foot conditions are contributing to the problem. Early diagnosis supports more effective treatment and helps prevent complications.

A podiatrist specializes in diagnosing and treating cracked heels while addressing the factors that contribute to the condition. Professional treatment focuses on reducing discomfort, improving skin health, and restoring normal foot function. A podiatrist also evaluates foot structure and walking mechanics to identify issues that may place excessive pressure on the heels. Early podiatry care can help prevent deeper cracks and reduce the risk of long-term complications. If cracked heels are causing pain or making it difficult to walk comfortably, it is suggested that you consult a podiatrist for an evaluation and appropriate treatment options.

If the skin on your feet starts to crack, you may want to see a podiatrist to find treatment. If you have any concerns, contact Dr. Thomas Madden from Advanced Foot Care Center. Our doctor can provide the care you need to keep you pain-free and on your feet.

Cracked Heels

It is important to moisturize your cracked heels in order to prevent pain, bleeding, and infection. The reason cracked heels form is because the skin on the foot is too dry to support the immense pressure placed on them. When the foot expands, the dry skin on the foot begins to split.

Ways to Help Heal Them

• Invest in a good foot cream
• Try Using Petroleum Jelly
• Ease up on Soaps
• Drink Plenty of Water

Ways to Prevent Cracked Heels

• Moisturize After Showering
• Skip a Shower
• Keep Shower Water Lukewarm
• Don’t Scrub Your Feet

If you are unsure how to proceed in treating cracked heels, seek guidance from a podiatrist. Your doctor will help you with any questions or information you may need. 

If you have any questions, please feel free to contact our office located in Killeen, TX . We offer the newest diagnostic and treatment technologies for all your foot care needs.