The most common cause of heel pain in children is calcaneal apophysitis, otherwise known as Sever's Disease. This condition is an inflammation of the growth plate on the back of the heel bone due to the pull of the Achilles tendon. On X-ray, the growth plate may appear to be fractured, but that is not really the case. What is true is the considerable pain, especially when engaged in athletics.
Most parents, and some pediatricians, write this condition off as growing pains. They feel that it will go away in time. This is true, Sever's is considered self-limiting, meaning if left alone it will eventually resolve on its own. The problem is that it can take weeks, months, or even years for the pain to finally be eliminated. For an active child who has to limit their sports or activity, this is not appealing.
The good news is, Sever's Disease is treatable with conservative measures. The first hurdle is bringing the child to see a podiatrist. Many people incorrectly feel that podiatrists are for older people. In truth, podiatrists see kids younger than age one, older than people 100 years old, and everything in between. A podiatrist will evaluate the child's biomechanics to see what is causing the inflammation to occur.
The inflammation can be managed with anti-inflammatory medication. Oral and topical medication is helpful for this purpose. Of course, ice is also helpful, since it has an anti-inflammatory effect. Don't keep the ice on for more than twenty minutes at a time, though.
A heel lift can also provide mechanical relief from the pulling of the Achilles tendon. Be sure, though, to only do this under the direction of a podiatrist, since the size of the lift may vary. In some cases, a more custom orthotic may be necessary to more comprehensively control the mechanics.
No pain is normal in a child. If your child is complaining of persistent foot or ankle pain, the sooner it is addressed, the quicker it can be completely resolved. This will allow your child to resume normal activity without too long a disruption.
Dr. Andrew Schneider is a podiatrist in Houston, TX and is the medical director of Tanglewood Foot Specialists. He treats all injuries and conditions of the foot and ankle. For more information and many informative videos, visit https://www.tanglewoodfootspecialists.com.
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