My Child Has Heel Pain. Is This Normal?

Heel pain in a child, contrary to popular belief, is not  normal and should be evaluated by a podiatrist promptly.  Heel pain in a child is usually due to an injury  in the heel. As a child grows the heel bone is not completely fused.  The area of injury in the heel bone is where the two pieces of bone fuse to become one. This is where injury occurs for children.  Typically, heel pain in children occurs in girls between 8 and 10 and in boys at 10 to 12 years of age. It is not until an adolescent turns around sixteen that the area completely fuses.  When an adult presents with this type of pain, it is more of an inflammation of the heel area and not a disruption or injury to the cartilage in the heel bone area. 

Sever’s diseases or  calcaneal apophysitis is often the cause of heel pain in children.  The typical pain is around the the sides of the heel, back of the heel, and on the bottom of the heel.  We will note if the pain increases with activity; especially during sporting activities.  The pain  will lead to tightness of various muscles because the body is compensating for the heel pain.  Achilles tendonitis commonly occurs along with the heel pain in the foot . The Achilles can get so tight that pressure of this extremely strong tendon against their heel  bone can traumatize the bone. This causes an injury of the growth plate of the foot. 

Treatment promptly by a podiatrist is necessary for heel pain in children. This will decipher whether there is an interruption in the growth plate or a real fracture, which is quite rare.  A foot specialist will take an X-ray and evaluate the bony structures of the foot and ankle area.  Once they are diagnosed with Severs disease or osteochondritis; the main focus is to decrease activity.  We typically don't recommend a complete cessation of activity but a decrease in physical sporting activity.  Icing the heel area for intervals of twenty minutes three times a day is very helpful.  Heel cups which are shock absorbers may be of some benefit.  In our practice we recommend custom orthotics  for this, which if casted correctly will effectively control the foot and ankle motion and decrease pressure in the heel area. Custom orthotics can also effectively decrease the pressure of the Achilles tendon on the heel bone.