Pediatric Care
Conditions & Injuries

Children's Services include:

Our office serves Pediatric patients from toddler to high school age!  Pediatric patients are not little adults, and we understand that!   Kids have growth plates, so injuries, from a twist or fall to a sports injury needs special care when evaluating the x-rays and the patient.  

Kids may heal a bit faster than adults, but it’s very important to discuss how active or what sports they can participate in and the proper timeframes. Proper rehabilitation and rest is paramount to preventing long term consequences like damaged ligaments, or improperly healed conditions.

In-Toe & Out-Toe conditions

Children may be born with rotational deformities of their legs, either above the knee, or below the knee. Typically if the knee caps rotates inwards and the feet point inwards as well, then the deformity lies in the hip area, either with a rotated internal hip socket, or the long leg bone (the femur) is rotated inward.

When the kneecap is straight but the feet are pointing inward, then the deformity lies within the tibia (lower leg) bone. The same principle can occur to cause an out toe problem. The in-toe condition is more common and can be treated, so proper evaluation is necessary to determine where the problem is occurring.

Some of these conditions can be treated with rotational bars prior to the baby ambulating, or later on with proper shoes, orthotic insoles and possible physical therapy.

Heel Pain

This is one of the most common conditions we see in pediatric patients. Usually occurring in very active or athletic children, it is rarely the typical “plantar fasciitis” that adults get, rather an inflammation of the growth plate in the back of the heel bone.

It is smart to treat early and confirm with x-rays, as there may be a problem with the foot alignment and/or other bone issues .

Sports Injuries & Evaluation

With the explosion of kids sports leagues and athletic programs, kids are playing sports at an accelerated pace and amount of time, than years earlier. 

Kids are not little adults, so there can be real concerns when kids have an injury. Most kids will not complain especially when very young, so if a child complains of pain, it is most likely very real

Proper evaluation of the lower extremity and possibly x-ray evaluation can help to determine the exact problem.


"I was very pleased with the care I received from Dr.Smielewski and all of the staff. I was given great treatment as well as hope for relief of pain. I felt only positive results are possible after visiting'"

- C.B.


Sports Conditioning Programs

The accelerated pace of sports programs requires that children be agile, flexible and strong.

It is not suggested for young children to do typical strength training like adults. However it is necessary and strongly urged for the kids to use simple age appropriate strength exercises to increase balance, and flexibility and sport specific strength. This is very important to prevent the possibility of injury. 

It is estimated that young athletic girls have a 8-10 times higher incidence of ACL injury in the knee.

The sports medicine community believes that these knee injuries can prevented by good solid strengthening, good postural control, proper jump mechanics, and evaluation of foot mechanics and shoe gear.

Scoliosis Screening

Our office screens all kids for scoliosis, as a general routine part of our pediatric exam.

Although not normal it is rather common, and should be watched and treated conservatively if possible with strengthening, proper shoes, lifts and/or orthotic devices to improve the motor patterns for the muscles and nerves that travel up the leg and up into the back.

If severe, x-rays can be obtained and referrals given as needed.

Ingrown Toenails

This is a fairly common problem for children as well as adults.

Sometimes the nails are either too wide naturally for the toe , or just curled too much in on the sides. Either of these patterns can cause irritation along the nail grove, and if clipped too short or traumatized, the nail can become infected, red, swollen, draining and painful.

A special simple procedure is the best option to alleviate the problem, immediately and will relieve the pain without the use of any antibiotics.

Pediatric Gait & Posture

Evaluating and screening children’s feet is very important for prevention of adult foot pathology (i.e. Bunions. Hammertoes.) Most children will not complain of foot problems, as the soft tissue and bony adaptations have not yet begun, but children may awake at night, or complain of foot or leg pain if increased walking or activity occurs.

Many mechanical foot deformities can impact posture, and create overuse injuries in the child from the foot upwards into the rest of the lower extremity. Common overuse pediatric injuries and conditions, can occur at the growth plates like the heel, knee or even in the hip area. Many of these injuries can be traced back at least in part to faulty foot mechanics.

Our office performs proper biomechanical evaluation of the lower extremity and feet for our pediatric patients, and can evaluate proper fit for athletic and school shoes. For children, prevention of injuries by proper mechanical evaluation is the key to preventing injuries and musculoskeletal complaints. When the evaluation determines that they are needed, utilizing foot orthotics for pediatric foot conditions is very proactive and cost effective.

We also screen all pediatric patients for any scoliosis or curvature in the back or pelvis. This should be conservatively cared for, and watched and treated with proper shoes, lifts and/or orthotic devices.

She always keeps in mind the movements of each sport and incorporates that into the treatment plan.