Pediatric Heel Pain

Prevention, Causes & Treatment of Children's Heel Pain

Pediatric Heel Pain & Adult Heel Pain are NOT the Same (and should not be treated the same).

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. 

Children’s Plantar Fasciitis?

Not likely. We have been seeing and treating children for heel pain at our clinic for over 9 years and have only had one case of pediatric plantar fasciitis. The child was 16 year old. The main cause of kid’s heel pain is Sever’s Disease. Sever’s accounts for over 90% of the kids we see and is the #1 cause of heel pain in kids.

The Most Common Causes of Heel Pain in Kids

(Click to view Sever’s disease videos below)

Did you know...?

1. The best ways to prevent pediatric heel pain is to:

  1. 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. Cleats generally don’t offer good support and a supportive shoe insole should be considered.
  2. Stretch before and after sports practices. Ensure your child is performing warm-up and cool-down exercises when playing sports.

2. 90% of the children we see for heel pain at Pediatric Foot & Ankle is caused by Sever’s Disease.

3. The most common misdiagnosis for children’s heel pain is plantar fasciitis. Most of all of these cases prove to be Severs. Kids and adult heel pain are different and should be treated differently.

4. The second most common cause of heel pain in children is Achilles Tendonitis.

5. A less common but not unheard of cause of children’s heel pain is juvenile idiopathic arthritis, formerly known as juvenile rheumatoid arthritis.

6. A pediatric podiatrist is the most qualified professional to diagnose and treat children’s heel pain and determine the best after care and prevention plan too. To schedule an appointment with Dr. Jarman, fill out our contact form or call (480) 534-7220.

The Most Common Cause of Children's Heel Pain

Sever's (Calcaneal Apophysitis)

In our clinic we see 2 to 3 children every day specifically for heel pain and 90% of them are experiencing a condition called Sever’s Disease. This is a syndrome of calcaneal apophysitis affecting 8 to 14 year olds where the growth plate on their heels has been injured.

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.

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 take x-rays to rule out the possibility of foot fractures. High quality digital x-rays are taken in office.

Digital x-ray machine in office at Pediatric Foot & Ankle

Symptoms

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.

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..

Chronic

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.

children's custom orthotic

Gracie's experience with Severs

Ryan's experience with Severs

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. Achilles tendonitis 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.

Heel fractures and foot 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.

Your child’s feet are designed for life

Make an appointment today if your child has Pediatric Heel Pain.
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