Heel Pain (Children)
Kids have it pretty rough. You may believe they have next to nothing to
worry about, having no jobs, playing all day, living in some idyllic
wonderland, but kids lives are often as complicated and stressful as
adults’, just in different ways.
Take adolescence, for instance. Middle school and junior high were pretty
much universally painful unless (or perhaps even if) you were one of the
few on the top tier of the popularity totem pole. Remember how you had to
deal with puberty, (possibly the most confusing and vexing period in any
given human life), the whims and caprices of your school teachers, crazily
fluctuating hormones, acne, and, on top of it all, your bones were still
trying to grow to fit that adult body you weren’t quite ready for.
When you’re born, much of your skeletal structure is made up of cartilage
rather than bone. As you grow older, your bones calcify, eventually turning
into those hard, mineralized structures we know so well. (And it’s probably
also why your mom keeps making you drink milk when you’re young.) The heel
bone (calcaneus) is no exception. In this bone, calcification begins at two
different spots, one near the center of the bone, and one at the rear of
the bone. Where these two areas of bone development meet, there remains a
thin band of cartilage known as a growth plate, or physis. It allows the
calcaneus to continue growing until about age 16, when the two areas of
bone development finally fuse together.
Occasionally in children ages 8 to 14, particularly in children who put a
great deal of stress on the heel bone (usually in sports like basketball,
soccer, or running), this growth plate can become inflamed, causing
significant pain in the heel. Wearing shoes with cleats, having tight calf
muscles, or being obese can also lead to or aggravate this condition.
Inflammation of this growth plate is known as calcaneal apophysitis, if
you’re into those medical terms, or is also referred to as Sever’s disease.
Pain in the heel from calcaneal apophysitis often develops quickly, and may
occur in one or both feet. (When it occurs in three feet, you probably have
more trouble than just an inflamed growth plate.) This pain may show up in
the back of the heel, to the side, or on the bottom, and squeezing the
sides of the heel is likely to cause pain. Your child may limp, walk on his
or her toes, or have trouble participating in sporting activities. Resting
the affected foot (or feet) usually offers some relief, but the pain will
show up again when the child resumes activity.
Because you’re a great parent, you’ll take your child in to see a
podiatrist as soon as he or she starts having symptoms of foot pain. Once
there, the podiatrist will probably ask you and your child about activities
the child has been participating in. You’ll likely also need to provide a
medical history. The podiatrist will perform a physical examination of your
child’s foot and leg, and may use X-rays or other imaging technology to get
a look at what’s happening with those growing bones.
Treating inflammation of the calcaneal growth plate usually involves
reducing the inflammation itself, and also attempting to minimize stress on
the area. First of all, your child will likely need to take a break from
the types of activities that can stress out the growth plate. (You may need
to let those dreams of your 10-year-old Beckham go for a little while,
until your child recovers.) Taking anti-inflammatory medication such as
ibuprofen can help, as can applying ice to the heel (20 minutes on over a
thin towel, 40 minutes off). Your podiatrist may also recommend
immobilizing your child’s foot by putting it in a cast (usually for about 2
to 6 weeks), but this is usually reserved for more severe cases.
Your podiatrist might also suggest orthotics, which are prescription shoe
inserts that can support your child’s individual foot shape. Or, your child
may also find stretching exercises beneficial; they work to diminish
tightness in the calf muscle and Achilles tendon, thus reducing the pull on
the back of the heel and the consequent stress on the growth plate.
Even after treatment, your child’s heel pain may not be fully resolved, or
may recur because the heel bone continues to grow. (Childhood really is
tough, isn’t it?) Fortunately, once the bone is fully fused together
(again, about age 16), this problem goes away, never to return. In a few
cases, children may simply need to have reduced activity until their bones
are fully developed. The good news is that, like many growing pains, this
particular problem doesn’t cause any more complications once the child is
Call 719-543-2476 today to schedule your appointment!