Dr. Nicole Cates is a board-certified foot and ankle surgeon and pediatric podiatrist with specialized training in pediatric foot and ankle conditions. During both residency and fellowship, she received extensive experience in diagnosing and treating pediatric foot problems, including congenital deformities, flatfoot, sports injuries, and growth-related conditions. She understands the unique challenges of treating children, ensuring that each treatment plan is tailored to their growing bodies. Whether through conservative care or surgical intervention when necessary, Dr. Cates is committed to providing expert, compassionate care to help children stay active and pain-free.
Pediatric Foot Care
Pediatric Flatfoot
Flatfoot, or Pes Planus, is a condition where the arches of the feet are either absent or flattened, leading to the entire foot making contact with the ground.
Causes and Risk Factors
Causes and Risk Factors include developmental factors, genetics, muscle imbalances, or tendon dysfunction. In rare cases, flatfoot can be caused by undiagnosed coalitions, which are abnormal bone growths leading to bone fusion in the foot.
Symptoms
Symptoms include foot fatigue, pain, and difficulty standing for long periods. Some children may avoid physical activity and sports due to discomfort.
Diagnosis
Diagnosis involves a physical exam and may include X-rays to assess the foot structure.
Treatment
Treatment may include supportive footwear, custom orthotics, or stretching exercises. The primary goal for pediatric flatfoot is to support the child’s foot as they grow, allowing them to engage in pain-free activities. Surgery is considered only as a last resort if conservative treatments do not provide relief.
Sever’s Disease (Calcaneal Apophysitis)
Sever’s Disease is an inflammation of the growth plate in the heel, common in active children and adolescents.
Causes and Risk Factors include repetitive stress or overuse, particularly in running or jumping sports, especially while the growth plate is still closing.
Symptoms include heel pain, particularly with activity, and tenderness around the heel.
Diagnosis is made through a physical exam and imaging studies to rule out other conditions.
Treatment typically includes rest, ice, NSAIDs, stretching exercises, and heel pads to reduce pressure.
Clubfoot
Clubfoot is a congenital deformity where one or both feet are twisted out of shape or position.
Causes and Risk Factors are not always clear, but they may be linked to genetic factors, fetal development abnormalities, or environmental influences. The risk may be higher if there is a family history or if there are issues during pregnancy, such as limited space in the uterus.
Symptoms include a foot that is abnormally turned, and in some cases, both feet may be affected. The deformity is usually noticeable at birth, and the foot may appear smaller and stiff.
Diagnosis is made through a physical exam shortly after birth. In some cases, imaging studies may be used to assess the extent of the deformity and guide treatment options.
Treatment: Early intervention is crucial for successful outcomes. Conservative treatments include the Ponseti method, which involves a series of gentle stretches and casts to gradually realign the foot. In some cases, a tenotomy (cutting of a tendon) is performed to release tight tendons. Bracing is typically used after casting, or surgical correction may be necessary to restore normal foot function and alignment.
Congenital Vertical Talus
Congenital Vertical Talus is a rare foot deformity where the talus bone in the ankle is positioned abnormally, causing the foot to be rigid and turned downward.
Causes and Risk Factors include abnormal fetal development. In some cases, it may be linked to other syndromes or genetic factors.
Symptoms include the affected foot appearing stiff, rigid, and turned downward. The deformity is noticeable at birth.
Diagnosis is made through a physical examination and imaging, such as X-rays, to assess the foot structure.
Treatment may involve a combination of casting, bracing, or surgery to correct the deformity. Early intervention is important to improve outcomes and function.
