WHAT CAUSES HEEL PAIN IN KIDS?
One of the most common causes of heel pain in kids is a condition known as severs. Severs disease, or Severs syndrome is a condition that occurs in children between the age of 7 and 14 years. This condition is known to be a growth plate problem and is associated with inflammation and irritation around the posterior aspect of the heel. Not all active children will develop Severs, but heel paid in kids is common who participate in lots of sporting activity. These children are sometimes going through a growth spurt. Heel pain and kids can lead to lack of participation and can cause the child to refrain from physical activity. These children will experience pain under the base of the heel and also around the back of the heel, and the discomforts can be relentless. The children will describe pain when walking and in particular when running or playing sports. Mums and dads are sometimes at a loss as they do not know what to do. There is nothing to see on the heel and bruising or inflammation are not associated with this condition. The condition seems to affect boys and girls similarly.
Quite often parents will visit the local doctor in order to seek advice and guidance, and they are often anxious to remove the pain from the child’s foot. Some doctors will refer for an x-ray of the foot but this is thought to be of little use. X-ray imaging does not lead to a specific treatment plan and is not always thought to be the correct approach when treating heel pain in kids. The x-ray images do reveal the growth plate and shows non-union of the heel bone, but this is normal for children in this age bracket.
TREATMENT FOR HEEL PAIN IN KIDS
The treatment for heel pain in kids should be a multi-factorial approach as there is more than one contributing factor to the pain. Footwear selection, calf stretching, assessment of biomechanics, elevating the heel and applying ice packs to the affected area are all treatments that should be considered in these children. Sometimes the use of prescription orthotics is beneficial for children who present with an inherent foot weakness. Not all kids with heel pain will require orthotics and some will benefit from simple heel wedges ranging from 7 to 10 mm. The application of cold packs will help to reduce pain and inflammatory change within the heel bone. Usually, footwear with an elevated heel and a small forefoot drop will allow the child to feel more comfortable. These shoes should also be relatively firm and robust and less flexible through the midsole. Heel Pain in kids is usually more manageable if the child is compliant with the above and in particular if they commit to regularly stretching the calf muscles. It is not usually necessary to refer for MRI or ultrasound. Sports podiatrists seem to have a good handle on Severs and physiotherapy is not usually necessary. Because children are young and healthy they seem to respond to treatment very quickly and very effectively. Severs can occur in 1 foot but is often seen in both feet. Parents can rest assured that the onset of the heel pain in kids is nothing to do with neglect on their part. The inherent foot weakness can sometimes be due to ligament laxity and while this is a genetic factor parents are not to blame.
OTHER CAUSES OF HEEL PAIN IN KIDS
It is important to consider other causes of heel pain in kids such as stress fracture
and bone bruising. While plantar fasciitis and Achilles tendinitis are more readily seen in adults, this is not to say that they cannot affect children too. Ultrasound imaging is often sufficient in order to diagnose plantar fasciitis or Achilles tendinitis. A bone scan would be useful in determining stress fracture or bone bruising. Once again, severs is the most likely cause of heel pain in kids who are active and aged between 7 and 14 years, but parents should know that regardless of the treatment options, children will always grow out of this condition once the heel bone has fused.
If you have a child with heel pain or if you would like to know more about heel pain in kids, please contact a suitably qualified sports podiatrist or reach out to the team at Sydney heel pain clinic.
Written by Karl Lockett