Heel Pain - Kids

Sever's Disease or Calcaneal Apophysitis sounds so dramatic and debilitating as a diagnosis for "heel pain". However, the diagnosis is descriptive for specific heel pain in kids age 8-14 years old. It means that the growth plate in the heel bone is aggravated or inflamed, and therefore it hurts. Frequently, this condition is seen during soccer season when your child is doing a lot of running and cutting type exercise. The soccer cleated shoe itself creates a very unstable surface to run on especially on hard Colorado soil. Complaints can be as mild as your child stating that they do not want to play, or as severe pain, and refusing to walk on it.

Additionally, your child is growing. The leg bone may be growing faster than the tendon and muscle group. This then creates tension at the heal bone where the Achilles tendon attaches and causes stress or strain to the growth plate. (The Achilles tendon is the strongest tendon in the body. )

Finally, kids feet are quite flexible. When they run, jump, make sharp turns etc., there is a significant amount of motion that occurs within the foot. This motion can be imagined as a twisting motion of the heel bone. Imagine twisting apart an Oreo cookie and that the filling is the growth plate.

Treatment:
1. Rest (easier said than done) However, "rest" can be reducing the forces that are aggravating the area. For instance, a 3- 6mm heel lift in the shoe to reduce tension of the Achilles tendon.

2. Orthotics: (another form of "rest") A custom orthotic (arch support), will help reduce the excessive motion or twisting of the foot therefore providing some "rest" to the foot.

3. Shoe Change: Cleats are hard and create an uneven surface. Changing the cleated shoe to a turf or non-cleated shoe can provide better stability.

4. Anti-inflammatories: Ice is the best but difficult to do with regard to time. Icing should be done before, during and after play. Ibuprofen can be used as directed.

If pain persists or is severe, than discontinuation of the activity is recommended. A cast and non-weight bearing may also be needed.

Conclusion: Sever's Disease, Calcaneal Apophysitis etc., is a relatively common problem in kids age 8-14 years. Just knowing what you are dealing with is half the battle and hopefully this article has shed some light on the subject. There is always the small percentage chance that the pain is due to something more severe such as a fracture or tumor and therefore if symptoms don't resolve quickly with the above mentioned treatment you should contact your Podiatrist.

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