Growing up is full of challenges. Learning to read, trying to make friends and fit in, and wanting to do well at sports are all part of your child’s life. Active children can face physical challenges as well, especially during growth spurts. One of them is childhood heel pain caused by a condition called Sever’s disease. If your child complains about pain at the back of their heels, here is what could be happening.
During a growth spurt, your child’s heel bone (calcaneus) develops more quickly than the Achilles tendon that attaches the heel and the calf muscles. That pulls the tendon tight. Then add the pressure of activities like running and jumping on a hard surface, which are common if your child enjoys sports like tennis, basketball, track, or gymnastics. This stress on already taut muscles and tendons causes the Achilles to pull against the growth plate of the heel where it is attached. When that growth plate is damaged, inflammation and pain results.
Other contributing factors are overpronation that twists the Achilles, flat feet or high arches that change the angle of the feet and stretch the tendon, and obesity, which adds even more pressure on the heel. This condition occurs most often during adolescent growth spurts—from ages 8 to 13 for your daughter, or 10 to 15 for your son. Once the heel hardens and stops growing in the later teen years, this childhood heel pain usually disappears.
Even if children don’t say anything to you, you may notice certain signs that they are suffering. They may limp after running, or have difficulty walking. They may walk stiffly or stumble about when they first wake up. You may also notice redness or swelling in the heel. If they take a few days off from activity, the symptoms may get better, and then return when they are more active again.
Taming the Pain
If you notice any of these problems, ask your child if the heel is painful, and come in to the office of Harvey R. Danciger, DPM to have us take a look at it. We will examine the foot and check different spots to see what causes the pain. We may also take an X-ray to rule out a fracture. The condition normally does not require surgery, but definitely does require time off from the activity that is injuring the heel. The pressure of the tendon pulling against the heel bone must be alleviated, and that means no running and jumping for a while.
We can show you some stretches your child can do to make the muscles and tendons more flexible. During healing, try putting ice in a towel and wrapping it under the foot, or give him or her a frozen water bottle to roll under the arch. Sometimes wrapping the area in a crepe bandage and elevating the feet can help relieve swelling and pain. Consult us before giving your child any pain relievers, though. Some—like aspirin—can cause serious complications and should not be used with children.
Quick action is crucial. If you catch this condition early and have kids rest from activity, most children will heal in 2 weeks to 2 months and have no recurring issues. Going forward, you can help by making sure your child’s shoes give proper support and don’t rub or press on the heel at all. Encourage stretching, ice the heels after activity to head off swelling, and monitor his or her weight. If needed, we can prescribe an orthotic device that keeps pressure away from the heel and tendon.
Childhood heel pain shouldn’t be one more challenge your child has to deal with, but if it is an issue, call Harvey R. Danciger, DPM in Palm Desert, CA at (760) 568-0108 for help. You can also request an appointment on our website. Be sure to follow us on Twitter and Facebook too for up-to-date information on your foot health.