The most common cause of heel pain in children is a disturbance or inflammation to the growing area at the back of the heel bone (calcaneus) where the Achilles tendon attaches to it. This is known as Sever’s disease or calcaneal apophysitis.
Sever’s disease is most commonly seen in children aged 10 to 14 years.
Symptoms of Sever’s disease
Sever’s disease can affect one or both heels, and will usually cause pain at the back and side of the heel bone. Pain is generally relieved with rest, and aggravated with activity such as playing sport, running, jumping. Squeezing the sides of the heel bone is often painful. In more severe cases, there may be limping.
What causes Sever’s disease?
Sever’s disease is related to repeated minor trauma to the bone and tendons in the heel. Some of the factors that can increase the likelihood of this occurring are:
- Playing sports or activities that involve a lot of heel movements
- Excessive weight bearing on the heel
- Tight calf muscles
- A pronated foot (a foot that rolls in), causing uneven weight bearing on the back part of the heel bone
How is Sever’s disease treated?
Sever’s disease is self-limiting; it will generally go away once the two bony parts in the calcaneus have joined together, which usually occurs around the age of sixteen. However treatment is recommended in order to reduce pain and to maintain activity levels as much as possible.
Orthotics are often beneficial in reducing heel pain in children. Custom orthotics can assist to control the biomechanics of the foot, and to reduce strain on the tendon that inserts into the growth plate at the heel.
In addition to orthotics, treatment for heel pain in children may include:
- Reducing sporting activities for a short period
- Footwear advice (it is best to avoid going barefoot)
- Use of a heel lift or arch support to reduce pull from the calf muscles
- Stretching exercises for calf and hamstring muscles
- Use of ice after activity