A complaint of heel pain from your child is a warning sign that deserves attention. Heel pain in children is often caused by injury to the growth plate commonly referred to as Calcaneal Apophysitis orSever’s Disease. A growth plate is an area of growing tissue within the bone that determines the future length and shape of the bone. Growth plate injuries of the heel are usually caused by overuse. However, pediatric heel pain may be the sign of many other problems, and can occur in infants through teenagers.
Your child’s symptoms may include:
- Pain in the back or bottom of the heel
- Walking on the toes
- Difficulty participating in normal activities or sports
How does Pediatric Heel Pain differ from adult heel pain?
During young ages (8 to 14 years old), bones are growing faster than tendons. At this time the heel cord is relatively short compared to the leg bone, causing the tendon to pull on the growth plate of the heel. When this is the case, a great deal of tension is put on the heel bone causing irritation and pain. The heel bone is still immature at this time and is therefore more prone to injury.
Pediatric heel pain usually does not improve with activity. In fact, walking typically makes the pain worse in children, whereas adult heel pain improves with activity.
Causes of Pediatric Heel Pain
- Calcaneal Apophysitis: Heel pain in children caused by injury to the growth plate in the heel bone
- Tendo-Achilles Bursitis: Inflammation of the fluid-filled sac (bursa) located between the Achilles tendon (heel cord) and the heel bone. May be a symptom of certain diseases such as juvenile rheumatoid arthritis
- Overuse Syndrome: A collective term for a range of conditions, including injury, characterised by discomfort or persistent pain in muscles, tendons and other soft tissues.
- Fractures: Heel pain caused by a break in the bone such as Stress Fractures
To diagnose the underlying cause of your child’s heel pain, East Penn Foot and Ankle Associates will first obtain a thorough medical history and ask questions about recent activities. A thorough exam of the child’s foot and leg, followed by X-rays are often used to evaluate the condition. In some cases the physician will order a bone scan, a magnetic resonance imaging (MRI) study, or a computerized tomography (CT or CAT) scan. Laboratory testing may also be ordered to help diagnose other less prevalent causes of pediatric heel pain.
Treatment of pediatric heel pain
- Reduce activity
- Cushion the heel
- Medications – Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as Advil (Ibuprofen) or Aleve (Naproxen Sodium)
- Physical Therapy – Rehabilitation program with Robbins Rehabilitaion
- Custom Foot Orthotic Devices
- Surgery – There are some instances when surgery may be required to lengthen the tendon or correct other problems
A complaint of heel pain from your child should not be ignored. Make an appointment with East Penn Foot And Ankle Associates to have your child’s complaints evaluated as soon as possible.