Children are resilient, but when your child begins to complain about heel pain, this must be taken seriously. Heel pain in a child is not normal. There are different causes of heel pain in a child and an adequate physical exam can help determine which type of heel pain is affecting your child.
What Is Calcaneal Apophysitis?
The most common cause of pediatric heel pain is calcaneal apophysitis (an injury or irritation to the growth plate of the heel). Typically, this occurs in boys (and girs) between the ages of 8 and 13 who are fairly active children. This is most likely to occur with a rapid increase in activity after a period of rest – such as starting rugby, soccer, netball and any in fact and sport practice after being off for a peiod of time.
Are There Other Causes of Pediatric Heel Pain?
Yes. Calcaneal apophysitis is the most common cause of pediatric heel pain. However, there are other things that can cause the heels to hurt such as stress fractures, growth plate fractures and hematagenous osteomyelitis, an infection of the heel bone.
Causes of Calcaneal Apophysitis
Causes of pediatric heel pain include:
- Rapid increase in physical activity (sports)
- Changes in training surfaces
- Changes in training techniques
- Changes in shoe gear (or going barefoot) while being physically active
- A rapid increase in growth over a short period of time
During periods of rapid growth, the bones of the leg grow faster than the soft tissues (muscles, tendons and ligaments) and the stress they place across the growth plate can cause pain and inflammation.
Symptoms of Calcaneal Apophysitis
Calcaneal apophysitis typically affects active boys and girls between the ages of 8 and 13; however, this condition can affect any active child. Early signs and symptoms include:
- Inability to participate in athletic activities
- Walking on the toes to keep the heel from touching the ground
- Pain in the heel that is worse after activity and relieved by resting
The Podiatrist will start your exam with a thorough history. This will be followed by a physical exam. During your physical exam, The Podiatrist:
- Pain and tenderness to the area of the inflamed growth plate
- A tight heel cord (Achilles tendon)
- Overall foot structure
- Abnormalities in gait
X-rays may be ordered to detect any underlying bone abnormalities.
Calcaneal apophysitis can be easily treated with changes in shoe gear, resting, icing, stretching and anti-inflammatory medications. Sometimes, physical therapy may be necessary, but this is rare.
Many times these types of injuries are unavoidable, but proper athletic shoes, stretching exercises and avoidance of obesity are some of the ways one can prevent an injury to the growth plate.
See The Podiatrist for expert care.