A parent’s guide from Bayshore Podiatry Center in South Tampa.

Quick take

• Teen foot pain is often mechanical: shoes, training load, growth, and structure all collide.
• “Bunions” in teens are real, but surgery is rarely the first step.
• Medial arch pain can be caused by an accessory navicular (an extra bone variant).
• Posterior ankle pain in dancers and athletes can be related to os trigonum / impingement.
• Persistent pain deserves a diagnosis before you guess treatments.

Table of contents

• Why teen foot pain is common
• Teen bunions (hallux valgus)
• Medial arch pain: accessory navicular
• Posterior ankle pain: os trigonum / impingement
• Ball-of-foot pain: Freiberg and other causes
• What you can do at home
• When to be evaluated
• How we evaluate teen foot pain
• FAQs
• Sources

Why teen foot pain is common

Teens often increase training intensity, change shoes, and go through growth spurts—all at the same time. This is where small mechanical issues become painful.

If your teen is playing through pain, the pattern often worsens, not improves.

Teen bunions (hallux valgus)

A bunion is a structural deviation at the big toe joint. In teens, genetics and foot structure often play a role.

What parents notice

• A bump at the base of the big toe
• Shoe rubbing and redness
• Pain after long days or sports
• The big toe drifting toward the second toe

What helps first

• Wider toe box shoes
• Padding to reduce friction
• Activity modification during flares
• Addressing contributing mechanics if present

What to be cautious about

Surgery in a growing teen requires careful timing and indications. The goal is function and pain relief, not chasing perfect cosmetic alignment. We often don't operate on children until the age of 16+ because of their continued skeletal development that can be impacted. 

Medial arch pain: accessory navicular

Some teens have an accessory navicular—an extra bone on the inside of the foot. Many never know it exists. Others develop pain at the medial arch, especially with increased sports, poor shoe support (especially cleats), or increase in running distances like track and field or cross country sports. 

What parents notice

• A prominent bump on the inside of the foot
• Pain with activity or certain shoes
• Tenderness at the bump
• Sometimes a flatter-looking foot on that side

Conservative treatment usually comes first

Supportive shoes, targeted inserts, temporary activity modification, and rehab can be very effective for many teens. Calf raises and strength training help this condition a lot. You can try some of our plantar fasciitis exercises found here to start! 

Posterior ankle pain: os trigonum / impingement

Posterior ankle impingement often shows up in athletes who repeatedly point the toes down (dance, soccer, gymnastics). An os trigonum is a common bony variant that can contribute to this pain. 

What parents notice

• Pain at the back of the ankle
• Worse with pointing toes (dancers), pushing off, or jumping
• Sometimes swelling or stiffness

Diagnosis matters here because the treatment depends on the exact cause. This is usually seen with a simple x-ray. 

Ball-of-foot pain: Freiberg and other causes

Ball-of-foot pain in teens can come from overload at the metatarsal heads. Freiberg disease is one specific condition involving the metatarsal head that can cause persistent pain. This can be serious and requries an x-ray sometimes advanced imaging like an MRI. Another common issue is something metatarsalgia which is an overload of the lesser toe joints in the forefoot. These issues can be caused by other walking or joint dysfunctions in the foot. Luckily, most forefoot conditions can be treated with exercises, pads or orhotic shoe inserts. Something to start with that helps are metatarsal pads. Be careful where you place them on the foot though as they can cause increased pain if placed improperly. 

If pain is persistent, it is useful to have ball of foot pain evaluated. This often starts with imaging to clarify the diagnosis and guide treatment.

What you can do at home (first 10–14 days)

• Reduce impact temporarily if pain is significant.
• Use shoes that fit and don’t compress the forefoot.
• Avoid “trying to stretch it out” aggressively if it increases pain.
• Metatarsal pads or gel insoles 
• Ice after activity can help symptom control.

If your teen is limping or pain persists, it’s time to be seen.

When to be evaluated

• Pain that persists despite short-term load reduction
• Limping or avoidance of activity
• Pain that returns immediately on resuming sports
• Visible deformity that is worsening
• Recurrent symptoms season after season

How we evaluate teen foot pain

We focus on:

• Pinpointing the pain source
• Assessing structure and function
• Reviewing training load and shoes
• Using imaging when needed to confirm diagnosis

Then we build a practical plan that gets them back to activity safely.

FAQs

Are bunions in teens “from tight shoes”?

Shoes can aggravate symptoms, but structure and genetics often play a major role. At this age, genetics are the largest factor. 

Do we need surgery for a painful accessory navicular?

Not automatically. Many cases improve with conservative care once the diagnosis is clear. 

Can my teen keep playing?

Often yes with modification, but pushing through persistent pain is rarely the fastest route to full recovery. We can help guide them back safely and prevent recurrent injuries! 

When to book an evaluation

If your teen has persistent heel pain or keeps flaring every time sports resume, we can create a clear plan to get them back to activity safely. Book a visit here! 

Bayshore Podiatry Center serves families all over the bay area conveniently located in South Tampa near Hyde Park.

Medical disclaimer

This information is for educational purposes only. Seek urgent care for severe pain after injury, inability to bear weight, fever, significant swelling, or rest/night pain.

Sources

• Harb Z, et al. Adolescent hallux valgus: systematic review of outcomes.
• Wynn M, et al. Nonoperative treatment of symptomatic accessory navicular in pediatric patients.
• Posterior ankle impingement / os trigonum reviews (pediatric and sports medicine)
• Freiberg disease references (orthopedic and sports medicine reviews)