Tag Archives: child heel pain

I Have Pain In My Heel – How Can I Treat It?

9 Sep

At one time or another during your life, you’re probably going to experience some degree of heel pain – just about everyone does. It might develop from playing basketball, not allowing enough time to rest in between runs, or even from doing nothing at all out of the ordinary. And you can develop heel pain at any age, including adolescence.

my heel hurts

The most common cause of heel pain in adults is Plantar Fasciitis.

The most common cause of heel pain is irritation or damage to the plantar fascia, the tendon that connects your heel to your arch. But heel pain can also be the result of damage or strain to the achilles tendon, which connects your heel to your calf muscle.

In children, heel pain is frequently associated with Sever’s Disease, a bone disorder caused by inflammation of the growth plate in the heel. Heel pain can also be the result of arthritis, bursitis, gout, a pinched nerve, a heel spur, a stress fracture to the heel bone (calcaneus) or other conditions. Because the possibilities are so numerous, it’s essential that you have your heel pain diagnosed by a podiatrist so that a proper course of action can be prescribed to heal your foot as quickly as possible.

The most common causes of heel pain

Plantar Fasciitis is by far the most common reason for heel pain. The classic sign of PF arrives first thing in the morning when you step out of bed – a sharp pain in your heel, which gradually fades as the tendon warms up with movement. But the pain may return if you exercise or stand for long periods. Read more about Plantar Fasciitis.

The Achilles Tendon is responsible for every step you take, and you couldn’t make a jump shot without it. When we demand too much of the achilles tendon, it becomes irritated or ruptured, causing pain that can be felt anywhere along the rear of the ankle, including the heel. Read more about injuries to the achilles tendon.

In children, Sever’s disease, known as calcaneal apophysitis, is the most common cause of heel pain. The inflammation of the heel’s growth plate is quite painful, and should never be ignored. Sever’s Disease is very common in obese children and those who play lots of sports, and most commonly occurs during growth spurts in adolescence.  Read more about heel pain in children.

How you can treat heel pain at home

Like the old saying goes, your best defense is a strong offense, and this is especially true when it comes to protecting your feet from heel pain. Always perform simple exercises to warm up your legs and feet before exercising. When tissues and bones are gently stretched before your game or workout, they’re better able to handle the load you’ll be demanding of them, and the less likely they are to become irritated or ruptured. See simple stretching exercises here. It’s also a good idea to slowly work up to your maximum, and not start out at full speed. And you should always wear a sturdy, supportive pair of athletic shoes to support your feet when exercising.

If you already have a mild case of heel pain, try:

  • Resting. Avoid doing the activity which caused the heel pain.
  • Stretch. Simple, gentle stretching exercises performed in the morning or evening can relax and strengthen the tissues which surround the heel bone.
  • Ice packs applied to your heel for 20 minutes at a time can reduce inflammation and pain.
  • Anti-inflammatory medicine like advil (ibuprofen) or aleve (naproxen) can be used to manage pain and reduce inflammation.
  • Do your shoes fit properly? In some cases, switching to a new pair of athletic shoes with excellent support of the arch and heel reduces symptoms considerably.
  • Download our free guide on treating your heel pain at home.

If you have heel pain that won’t resolve with in-home treatment, make an appointment with your podiatrist for a diagnosis and treatment plan. He or she may choose to treat your heel pain with steroid injections, immobilization, physical therapy, custom in-shoe orthotics, or other non-invasive procedures. If your heel pain is serious and chronic, surgery may be recommended.

Why You Should Skip the Flip-Flops This Summer

7 May
Flip-flops are just so easy – slip ’em on and run out the door. Seems like everybody starts wearing them as soon as outdoor temps climb above 50 degrees.


Unfortunately, flip-flops are just about the worst thing you can wear on your feet. In fact, there is a growing problem of heel pain among teens and young adults, which podiatrists are attributing to wearing this paper-thin footwear (no doubt intensified by the obesity epidemic).

Walking barefoot is better for your feet than walking in flip-flops. If your feet have any abnormal biomechanics, flip-flops can accentuate these problems, leading to plantar fasciitis and accelerating other foot problems.

Think about it: the bones in your feet are the base of your skeleton and your body weight is riding on them. If your feet aren’t supported correctly, the rest of your bones, joint, tendons, and muscles have to make up for it. The stress shifts elsewhere and that leads to foot pain, heel pain, leg pain, hip pain, bad knees, sore back, and any number of other ailments.

Naturally, wearing flip-flops in the sauna, locker room, or by the pool won’t cause any harm. But as everyday footwear, we suggest you make a smarter choice.

So how exactly do flip-flops affect your feet?

Toes: That little thong that slips between your toes actually makes the muscles in your feet work overtime. The perpetual gripping this requires of your feet can lead to a nasty case of tendinitis, hammertoes, and bunions. Additionally, bare skin rubbing against the plastic or leather thong can lead to nasty blisters.

Fractures: With no support under your feet, all of that pressure from your body weight can create stress fractures in the bones of your feet. If you spend a lot of time on your feet in flip-flops, this is very likely to occur.

Bottom of your feet: The flip-flop isn’t stationary on your foot like an athletic shoe is. Since the bottom of your foot is in a constant sliding motion against the material, it can create a burning feeling or blisters, especially on hot days.

Arch and heel pain: If your footwear doesn’t support your arch, you run an excellent chance of developing plantar fasciitis, the inflammation of the band of tissue which runs along the bottom of your foot, connecting your heel to your arch. Pain may be felt anywhere along the plantar fascia.

For summer footwear, we suggest that you always wear athletic shoes that fit properly or a solid, rugged pair of sandals with significant arch support and a heavy sole.

Thanks to Huffington Post for this excellent infographic on what happens to your feet when you wear flip-flops.

flip flops

What Is Sever’s Disease?

10 Oct

Sever’s disease, known as calcaneal apophysitis, is the most common cause of heel pain in children.  It’s a painful bone disorder created by inflammation of the growth plate in the heel, usually from muscle strain and repetitive stress. Sever’s Disease is very common in obese children and those who play lots of sports, and most commonly occurs during growth spurts in adolescence.  For girls, this is usually between 8 and 13 years of age, and for boys, between 10 and 15.

heel pain children

The heel is especially susceptible to injury in children. The foot is one of the first parts of the body to grow to full size and the heel area is not very flexible. The growth plate is a soft area at the end of the heel bone where cartilage cells change into bone cells, and it eventually fuses with the heel bone.

During the early part of puberty, the heel bone sometimes grows faster than the leg muscles and the Achilles tendon, which attaches the calf to the heel bone. When this unequal growth occurs, the muscles and tendons become very tight, which makes the heel less flexible, placing a lot of stress on the growth plate. The Achilles tendon, when stretched too tightly, becomes swollen, tender, and painful where it attaches to the growth plate. This injury, a result of repetitive stress on the Achilles tendon, is Sever’s Disease.

If  a child is active, doing a lot of running, jumping, and playing on hard surfaces, they can put a lot of stress on those too-short muscles and Achilles tendon, resulting in heel pain. Other factors which can contribute are:

Severs-Disease heel pain children

  • Long periods of standing which put constant pressure on the heel
  • Pronated foot (a foot that rolls inward when walking). Pronation tightens and twists the Achilles tendon and pulls on the growth plate
  • Flat feet or a high arch. This again cause the Achilles to be overstretched
  • Short leg syndrome, in which one leg is shorter than the other. This causes the foot on the short leg to bend downward, putting stress on the Achilles
  • Obesity  – weight puts pressure on the growth plate

Symptoms of Sever’s Disease

  • Pain or tenderness in one or both heels. Pain is usually felt at the back of the heel, but may also be felt along the sides and bottom of the heel, all the way to the arch.
  • Swelling and redness in the heel
  • Feet are stiff upon waking
  • Difficulty walking or running
  • Child may walk on tiptoes or with a limp to avoid putting pressure on the heel
  • Pain may increase with activity

To relieve symptoms

  • Rest to relieve pain
  • Curtail athletic activities
  • Wear athletic shoes that fit properly and provide cushioning
  • Ice and elevate the sore foot to reduce swelling
  • Stretching exercises for the heel and hamstring
  • No high heeled shoes
  • Over the counter pain medicine (check with your doctor first)
  • If symptoms are caused by obesity, a weight management plan

Sever’s Disease fortunately is a temporary condition. With proper care and treatment, symptoms will usually go away within 2-8 weeks, and it will have no long term consequences. If the condition recurs due to the child having a pronated foot, or a flat or high arch, your podiatrist may recommend custom orthotics to position the foot correctly inside the shoe and reduce stress on the heel.

The risk of recurrence of Sever’s Disease diminishes with age, and as a rule won’t occur after the age of 15. By that time, foot growth is complete and the growth plate has fused to the rest of the heel bone.

Buying Athletic Shoes For Kids: Avoid Hand-Me-Downs

22 Aug

athletic shoes kidsIt’s true that every parent with young children wants to save a buck wherever possible. You might be tempted to hand down your 12 year old’s outgrown shoes to your 10 year old, but you might want to think twice before doing that, especially when it comes to athletic shoes.

Sneakers, cleats, and any shoes made for athletic training need to fit every foot correctly. Considering the heavy beating a foot takes when they’re in these shoes, this is not an area to skimp. Your child will be running, jumping, and kicking, and their feet require padding and comfort to not only perform as well as possible, but to protect their feet from injury. Athletic shoes that are too tight will create blisters, corns, calluses, redness, sores, or ingrown toenails. Those that are too loose will allow the foot to slide, putting undue stress on the toes.

Hand-me-downs also may provide less support for the arch and heel than what’s needed. “Shoes lose their shock absorption over time, and wear and tear around the edges of the sole usually indicates it’s worn out and should be replaced.”, notes Dr Teichman at PA Foot and Ankle Associates. “If a child keeps wearing worn-out or non-supportive dress or athletic shoes, it elevates the risk for developing heel pain, Achilles tendonitis and even ankle sprains and stress fractures.”

When you’re buying new shoes for your child, make sure they’re not too tight, and resist the urge to buy a pair that are slightly large, believing that your child will “grow into them”. And with the innovations in shoe design and construction, modern materials don’t need to “break-in”, like they did years ago.

How to know if the shoe is right for your child:

  • Make sure there’s a finger’s width distance in the shoe box between the longest toe and the front of the shoe
  • No redness should appear on the child’s feet after taking the shoes off. Redness is a sign of the shoe rubbing or pinching
  • The shoe should not bend in the middle of the sole, it should bend at the ball of the foot
  • The toe box should flex easily
  • The back of the shoe should meet your child’s foot, but not be tight
  • Shoes should be made of quality materials which will cushion the foot
  • The toe box should be roomy enough that your child can wiggle their toes

Your child’s shoes not only protect their feet from injury this year, but also protect them from developing foot problems which may follow them into adulthood. Take the time and choose wisely.

Heel Pain in Children: Warning Signs For Parents

7 Jun

There’s simply no substitute for organized game play in a child’s physical, emotional and mental development. Even non-organized physical activity is important, like climbing trees, going for a swim on a hot Saturday, or riding a bicycle to a friend’s house.

child heel pain soccerBut kids are notorious for not complaining about their injuries, for any number of reasons. And injuries at such a young age can literally change the development of every muscle in their body, as the uninjured parts compensate for the injured parts. As a parent, you need a sharp eye to watch for changes in behavior or body language, even though we all know how hard that is.

Signs of possible unspoken injury to a child’s feet or ankles may include changes in their gait, occasional limping, favoring one foot over another, walking on their toes, problems running, or unusual fatigue.

The most common sports injury in children is heel pain. Many times this can be simple plantar fasciitis from overuse, usually controlled with pain medicine, rest, icing and if necessary, physical therapy and custom orthotics to be worn in their shoes. But it may also be a sign of Sever’s disease, an inflammation of the heel’s growth plate due to muscle strain and repetitive stress. This is especially common in highly active children and those carrying extra pounds.

Bear in mind that the symptoms of heel pain in adults are considerably different than heel pain in children. In adults, heel pain is usually worst in the morning upon rising, and subsides as the tissue warms up with light activity. But in children, heel pain usually doesn’t diminish as the child moves around – in fact it may get much worse.

If your child complains about heel pain, don’t take it lightly. Make an appointment with our office immediately for a thorough diagnosis, because early intervention is key to a continued healthy development.

What is the benefit of custom foot orthotics?

5 Feb

Shoe inserts from a drug store or shoe store are not to be confused with custom made foot orthotics. Most everyone has tried over the counter shoe inserts at some time in their life, and most everyone has been disappointed with them. That’s because there’s no such thing as an “average foot”, so a one-size-fits-all solution for foot pain doesn’t exist.

custom made foot orthoticsOrthotics are custom made shoe inserts. They can only be ordered by a medical professional after an examination of your feet, your gait, your pronation, and an analysis of any pain you may be experiencing. Issues resulting from heel pain, bunions, plantar fasciitis, flat feet, high arches, abnormal biomechanics, or poor lower limb alignment can all be addressed with custom designed orthotics, which can be made to cushion sore areas and correct abnormalities. They can also be very helpful for athletes, especially runners who have recurring problems with their feet.

Orthotics are made from more durable materials than over the counter shoe inserts, and they last for years, not months. Orthotics are custom designed specifically for your foot to improve your running, walking, and balance by supporting the arch, cradling the heel and rotating your foot into a “neutral” position. This support and proper pronation helps the foot function at its maximum level. When your foot is balanced and supported correctly, you’re less prone to ankle or foot injury, knee pain, hip pain, and back pain as well. After all, your entire body is riding on your feet.

For athletes, foot orthotics can help reduce foot stress and fatigue, and may also increase agility. By balancing the foot, shock absorption will improve, diminishing before reaching your limbs.

How do I know if I’ll benefit from custom orthotics?
  • Look at the bottom of your shoes to see if they are worn evenly across the toe or heel area. Even wear-and-tear indicates your gait is normal, but if they wear out too quickly or unevenly, then you may benefit from orthotics
  • Do your feet hurt after being active? How about your ankles, knees, hips, or back?
  • Do you have unusually high arches?
  • Do you have flat feet?
  • Do you have tendonitis, shin splints, hammer toes?
  • Are your legs consistently tired or aching?
  • Do you have diabetic foot problems or a neuroma?
Only a podiatrist can tell if custom made orthotics are right for your feet, but most patients notice an immediate difference in comfort and stability, and their pain is sharply reduced or eliminated.

Red Sox’ David Ortiz to undergo PRP Therapy for Achilles injury

29 Aug

David Ortiz (aka “Big Papi), the Designated Hitter for the Boston Red Sox is back on the 15 day DL. The right Achilles tendon injury which benched him for 35 games this season was aggravated during Friday night’s game against Kansas City, in which he went 2 for four with a double. Ortiz, who has a career batting average of .285 with 401 homeruns and 1,326 RBI’s, will have a PRP (platelet-rich-plasma) injection this week, in an attempt to heal the injury without surgery.


According to the Boston GlobeOrtiz said he… hoped [the PRP injection] would give him a “60-70 percent’’ chance of getting back to make a contribution during the final 33 games of the season.

“You guys know I live for this [game],’’ he said. “And there’s not one thing that I would like to do more than be out there performing for our fans. I had one [PRP injection] done before and I believe in that big-time.” (His previous PRP injection was in 2007 to help heal a knee injury).

What is a PRP injection?

PRP stand for Platelet Rich Plasma, a treatment which involves using the patient’s own blood to speed healing.  PRP is used to treat Achilles tendon injuries, arthritis,  muscle tears, plantar fasciitis, scar tissue and certain other painful conditions.

How PRP works

A small amount of the patient’s blood is drawn and then run through a centrifuge, which draws off and concentrates the platelets and some white blood cells, creating the Platelet Rich Plasma. This is then injected into the injured area to speed up the healing process. Depending on the severity of the injury, the treatment may require 3-7 injections 4-6 weeks apart.

“I thought I was going to be OK until I hit that double and I had to rush out to second base,’’ Ortiz said. “I felt that pain because I was running with the game intensity. The way I feel right now, it wasn’t right.’’

“I want to be careful with it because… if you’re sore, you know your body’s telling you something, and if you continue doing damage on top of it from what you already have, then it costs you a surgery. That’s why we’re trying to be careful.”

Listen to Big Papi! Pain is the body’s way of telling you that something’s wrong.

PA Foot and Ankle Associates is the Lehigh Valley’s leader in treating foot and ankle-related sports injuries. PAFAA may recommend Platelet Rich Plasma injections when other therapies and anti inflammatory medicines are unsuccessful in eliminating pain.


My child has flat feet – what should I do?

12 Jun

If your child has flat feet, there may be no need for worry – it could be normal for their age.

my child has flat feet

Many parents become concerned when they notice that their child has flat feet. Depending on the age of your child, it may be nothing to worry about or it may indicate fallen arches, which Podiatrists call pes planus.

When a child is born, their feet are definitely flat – well, more like chubby. That’s because the foot needs to be very flexible while the baby is in the womb. Until a child is about three years old, her foot is made mostly of cartilage and you’ll notice very little change in it’s appearance until her feet are bearing weight – standing, walking, running.

Between the ages of two and three, your child’s foot will start to show it’s true shape as her baby fat and cartilage diminish and the bones become more prominent. Ligaments and tendons start to strengthen at this time as well. Yet, the foot may still look flat. In fact, 90% of two year olds exhibit flat feet, but by the time they’re ten, only 10-15% have flat feet.

When does the arch of the foot form?

The arch of the foot begins to develop between the ages of two and four, as your child walks more and more. Your child is growing, changing posture, and building their muscles, and as they do, the tarsal bones develop in the foot and the connective tissues that bridge the midfoot.  Thus, the arch forms… or doesn’t.

If your child is halfway through their second year and their arch is still not developing, then it’s time to visit East Penn Foot and Ankle Associates for a complete diagnosis of your child’s foot.

A study published in 2009 found that overweight children have a higher incidence of flat feet than children of normal weight. The cause and effect is unclear and it remains to be seen if overweight kids will grow into adulthood with pes planus.

When do I need to worry about my child’s flat feet?

If your child’s feet are still very flat by the time she is eight years old, she will likely complain of aching, fatigue in her legs or arches, and difficulty keeping up with other kids during athletic activities. She may also complain of pain or fatigue in the lower back, hips, knees, or legs due to the compromised mechanics caused by the flatfoot deformity. This is when you should call a podiatrist for a thorough examination of your child’s foot and a course of treatment.

normal foot flat foot compared

Treatment for flat feet

If your child has a mild flatfoot deformity and no symptoms, your podiatrist may simply recommended a yearly check-up to monitor the development of their feet. If your child has a moderate to severe flatfoot deformity and does have significant symptoms in the foot or lower extremity, treatment may include:

  • Supportive shoes
  • In-shoe inserts such as arch padding
  • Functional foot orthotics which limit the abnormal flat arch and stabilize the heel
  • Calf muscle stretching exercises – tight calf muscles may worsen flatfoot deformity and make symptoms worse
  • Surgery in the most extreme cases

The biggest question a physician must answer when examining your child’s feet: Will this child’s flat feet remain stiff and inflexible into adulthood?  Some flat feet remain that way but create no symptoms. Others remain stiff and inflexible, with the loss of inward and outward movement (inversion and eversion). In this case, they can be responsible for quite a bit of discomfort. A podiatrist is expert at spotting inconsistencies in the structure of the foot and is in the best position to ascertain how serious your child’s problem is… or will be.

How can my child avoid getting flat feet?

Here’s some food for thought: Researchers in India found that flat feet were far more prevalent among people who wore footwear before the age of six. Kids who went barefoot for most of their first six years – the formative years for feet – had better developed arches and exhibited flat feet far less often. No other factors had comparable impacts. It may seem counterintuitive to parents, but letting young children run barefoot as often as possible may be the best way to insure that their feet develop properly.

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