Pediatric Heel Pain
Causes of Pediatric Heel Pain
Like adults, children may experience heel pain. But, unlike adults, pediatric heel pain is typically caused by Sever’s disease, not plantar fasciitis (although children may get plantar fasciitis).
We find that parents often dismiss a child’s heel pain as a normal part of growth. It is not. And, even though most heel pain is not a sign of something more serious, it should be evaluated by a pediatric podiatrist. On this page, we describe the common types of pediatric heel pain, including symptoms, causes, and treatment.
How to Prevent Pediatric Heel Pain
The best way to prevent pediatric heel pain is to ensure your child wears high-quality shoes that offer ample support. This is true for both “everyday” shoes and those required by the sport they play.
If your child participates in soccer, basketball, dance, or track, make sure they do plenty of stretching exercises afterward. If they complain of heel pain, elevate the foot and apply ice, making sure the cold pack never directly touches their skin.
A pediatric podiatrist can diagnose the cause of your child’s heel pain and determine the best treatment. To schedule an appointment with Dr. Jarman, fill out our contact form or call (480) 534-7220.
Common Cause of Pediatric Heel Pain (Calcaneal Apophysitis)
The most common cause of pediatric heel pain is Sever’s disease (aka calcaneal apophysitis). This overuse injury occurs most often in athletic children aged 8 to 14, but may occur as young as 5.
What causes Sever’s disease?
Sever’s disease is most often caused by the child’s foot repeatedly striking hard surfaces, which stresses the growth plate in the heel. This plate, called the physis, becomes inflamed and painful. If your child plays basketball or soccer, or runs track, they are more likely to develop Sever’s.
Other causes of Sever’s disease include:
- A tight Achilles tendon
- Arches that are high or flat
- Having one leg that’s shorter than the other
- The foot “rolling” at the ankle (pronation)
Symptoms of Sever’s disease
The most common symptom of Sever’s disease is heel pain. This pain usually gets worse the more the child walks, not better. Since walking normally is painful, the child may walk on their toes or limp. They may also stop participating in sports they used to enjoy or stop performing as well.
Diagnosing Sever’s disease
Dr. Jarman begins by taking the child’s medical history, paying special attention to activities they participate in, such as sports played. The physical exam includes gently squeezing the sides of the heel and having the child stand flat and then on tip-toe. Pain felt during any of these tests may indicate Sever’s disease.
Finally, Dr. Jarman may order x-rays to rule out the possibility of foot fractures.
Treating Sever's disease
Treatment depends on whether your child has acute or chronic Sever’s disease.
Acute treatment begins with resting the foot by reducing activities for one week. Dr. Jarman may also recommend over-the-counter anti-inflammatory medications (i.e. ibuprofen). He may also suggest a change in shoe gear and an over-the-counter gel heel cup.
If acute care fails, Dr. Jarman begins treatment for chronic Sever’s disease. This includes correcting your child’s gait (how the foot hits the ground) and a custom orthotic to relieve pressure on the growth plate and stop the pain. In extreme cases, your child may require a cam boot to completely immobilize the foot for two to three weeks.
Other Causes of Heel Pain in Children
Other causes of pediatric heel pain include Achilles tendinitis, plantar fasciitis, and fracture.
Achilles tendinitis occurs when the tendon connecting the calf to the heel (the Achilles tendon) becomes inflamed. This typically happens after a sudden increase in activity, such as beginning a new sport. Treatment includes resting and elevating the foot as well as ice to relieve swelling. Dr. Jarman may also prescribe wrapping the foot to help support the Achilles tendon during activities.
Plantar fasciitis occurs when the band connecting the heel to the rest of the foot (the plantar fascia) becomes inflamed due to overuse. It is more common in adults but may occur in children. Unlike the pain from Sever’s disease, most people with plantar fasciitis experience relief of symptoms once they walk around for a bit. Treatment may include:
- Ice and elevation to relieve inflammation and discomfort
- Massage and compression
- Resting the foot
Heel fractures may occur due to acute injury or repeated stress. They’re most common in children who play high-impact sports. Conservative treatment includes immobilizing the foot, rest, and medication to manage pain. Dr. Jarman may also prescribe physical therapy to return full function to the foot.