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A Parent’s Guide to Children’s Heel Pain

When you’re raising a rowdy, active young athlete, bumps, bangs and bruises are normal. Most of their time, the gift of youth allows them to bounce back from these injuries. But not all aches and pains are equal, and appearances can be deceiving. Some require more intervention than others. Foot injuries are a perfect example. When your child complains of heel pain, how can a parent know if it is just another bruise, or Sever’s disease? What are the signs? How severe can it get and what are the treatments? Let’s take a closer look.    

So, What is Sever’s Disease?

While not a disease in the traditional sense – such as those that affect major organs – Sever’s disease is the most common form of heel pain in children. Growth plates in children, such as the one at the rear of the heel, continue to mature until mid-teenage years. Overuse, excessive pulling of the Achilles Tendon or repeated impacts of the heel’s growth plate can cause painful inflammation.

Who Develops Sever’s Disease?  

Several factors cause calcaneal apophysitis, another name of the condition. Overuse is a major source of Sever’s disease, which is most common in children ages nine to fifteen. At that age, young athletes generally graduate to competitive sports, which require more training and competitions. A majority of cases appear in sports with lots of running and contact, such as soccer, football, lacrosse and field hockey. 

Other factors include:

  • Growth plate injury, such as an impact 
  • Greater wear-and-tear on feet, due to weight gain or increased activity, both of which are common in early and middle-age teens 
  • Higher or lower than average foot arches can predispose children to the condition

What’s the Worst That Might Happen? 

Sever’s disease leads to a spectrum of discomfort, such as mild aches or soreness that leads to a limp. When untreated, children with painful calcaneal apophysitis may adjust their walk, run or other movements to avoid heel discomfort. This adjustment may result in an unnatural, unhealthy or less energy efficient movement, which – during a vigorous activity, such as a sport – can lead to further injury.    

What Treatments Are There?   

Fortunately, Sever’s disease is relatively easy to manage. Solutions for mild symptoms include: 

  • Anti-inflammatory, pain-relieving medicines, such as aspirin or ibuprofen 
  • Shoes or custom orthotic inserts that provide excellent arch support
  • Cushioning from heel cups 

Additionally, it is sensible to replace shoes that are well-worn and no longer provide adequate arch support. This applies to both casual and athletic footwear. 

Activity Modification

Outside of over-the-counter remedies is activity modification, or a reduction in vigorous activity. These days, a greater share of young athletes are cramming their weeks with training and weekends with competitions. My experience has shown that this is a recipe for overuse and can inflame the heel’s growth plate. Often, I recommend athletes reduce practice sessions and increase rest intervals. With the right balance of activity and recovery, painful symptoms lessen over time.

Consult a Specialist

Of course, every child is different. And the fastest route to pain relief – and getting back in the game – is to consult a foot and ankle specialist. Here’s what you can expect: 

  • Insightful questions about past and recent activity
  • A thorough examination of feet, ankles and legs
  • If required: imaging, such as x-rays, for enhanced diagnosis 
  • And a carefully considered plan to reduce the frequency and length of training sessions

Schedule an appointment today at one of my four convenient locations, and let’s work together to find the right combination of short- and long-term solutions for your child or young athlete.