Heel Pain in Children Who Play Sports

Does your child play sports and complain that his heel hurts? Do you notice your child limping after running? Does your child complain that his heel hurts only during PE? Is your child overweight and complains whenever he has to run? Do any of these sound familiar? Take these complaints seriouisly becuase your child could have Sever's disease.

Who is at risk?
Heel pain in children is usually caused by a disturbance to the growth plate located at the back of the heel bone. This is known as Sever's disease, or calcaneal apophysitis, an inflammation of the growth plate of the calcaneus. It is most common in boys between the ages of 10 to 14 years who play sports with a lot of jumping (like basketball) or other sports that can cause repetitive minor trauma to the heel. It is also more common in children who are overweight, children who have a tight calf muscle, and children who are over-pronators (foot rolls inward when weight bearing).

What are the symptoms?
Pain is usually felt at the back and sides of the heel bone. Sometimes there may be pain on the bottom of the heel. The pain is usually relieved when the child is not active and becomes painful again while running, jumping, or playing sports. One or both heels can be affected. In more severe cases, the child may be limping.

How is it diagnosed?
If your child is complaining of these symptoms, a consultation with a podiatrist will be necessary to rule out other problems. The doctor will need to perform a complete podiatric examination on the child, including a gait analysis and biomechanical measurements. X-rays will also need to be taken in the office. A diagnosis can then be made.

How is it treated?
1. The physician will recommend that the child cut back on sporting activities until symptoms improve; however, if the condition has been present some time, a total break from sports may be needed.
2. Proper shoe gear with a soft cushioning heel lift is important to reduce the pull from the calf muscles on the growth plate. This will also increase shock absorption, so the growth plate is not subject to as much repetitive minor trauma. It is important not to allow the child to walk barefoot until symptoms resolve.
3. Stretching exercises will be prescribed by the podiatrist, provided the stretch does not cause pain in the area of the growth plate. Heel raises and gastrocnemius/soleus stretches will be recommended.
4. The doctor will recommend the use of an ice pack after activity for approximately 20 minutes. This should be repeated 2 to 3 times a day.
5. Since over-pronation is common in these pediatric patients, orthotics will most likely be prescribed for long-term treatment and prevention of recurrence of the pain.
6. Strapping or taping of the foot can also help during activity to limit the ankle joint range of motion.
7. If the symptoms are severe and not responding to the other treatments, anti-inflammatory medications may be prescribed to reduce inflammation.
8. In more severe cases, a below the knee cast or walking boot can be used for 2-6 weeks for immobilization of the foot and ankle.

Don't delay seeking treatment for your child!

For questions, please do not hesitate to call our office for a free consultation at (626) 442-1223.

Dr. Michele Colon, DPM
3503 Lexington Ave.
El Monte, CA 91731
www.footdoc.moogo.com