Do you notice that your child complains of heel pain especially after running, jumping, or playing sports? Is the pain on the back of the heel? No parent likes to see their child in pain. Often the first causes that come to mind are the scariest: tears, breaks, and perhaps…cancer. Although these fears are occasionally legitimate, most often the pain is not a threat to the health and well-being of your child. In fact, the pain may be easily treated at times. One of the major causes of heel pain in children, especially in boys, is a condition called Sever’s Disease. The Achilles tendon on the back of the lower leg is pulling on a secondary ossification center (that allows bones to keep growing as the child grows) and causing inflammation and pain from overuse. Another way to describe the condition is growth plate swelling. Children usually first notice it around 8 or 9 years old with high impact activities and notice that rest improves the symptoms. When you see the podiatrist, they may recommend radiographs to confirm the diagnosis and rule out any other problems.
Your podiatrist may recommend the following for pain relief:
- Activity modification including avoidance of running and jumping
- They may recommend that the child put sports on hold if possible until the symptoms full subside
- Daily stretching to reduce equinus (contracture of calf muscles) can help reduce the pull of the tendon
- Heel lifts in the child’s shoes to allow relaxation of the Achilles and reduce pull on the heel bone – bring in your child’s shoes that they wear (all of them) to ensure fit of heel lifts
- Ice at the heel or behind the knee may be recommended with a simple warning to keep the cold exposure to no more than 20 minutes at a time
- Ibuprofen or naproxen may be taken orally to reduce symptoms, but they do not “cure” the problem, but rest may
- They may recommend a CAM walker and crutches during the first two to three weeks of symptoms if it is caught early
- While in the CAM boot, the child may still use a stationary bike or swim to stay active and limber
- Physical therapy may be used to increase the strength of the athlete and improve control of motion around the ankle
If the symptoms do not resolve, an MRI can be ordered to determine a separate cause the child’s pain. Sever’s apophysitis is not a condition to worry about but it is a condition that should be treated early to reduce pain and return the child to sports and daily activities. If instructions from the podiatrist are followed, most cases resolved within a few months.
Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office