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The Most Common Cause of Children’s Heel Pain is a growth plate injury
We know you want your children to be healthy and happy. Of course, children’s heel pain can keep both of those from happening.
Children’s heel pain is most likely Sever’s disease (calcaneal apophysitis) and it is a common problem in a developing foot. This isn’t actually a disease, but more of a “growing pain” that keeps your pre-teen from activity and enjoying their favorite sports. Even our own Dr. Leibovitz was affected when he was young and he wishes he knew then what he knows now.
Fortunately, we have some good news:
And, even better, it does NOT require surgery!
Feel free to keep reading to learn more about this problem and the conservative treatment options we offer. Or, if you’re ready to schedule an appointment for your son or daughter now, please call our office at (317) 545-0505 or contact us online.
Why does your child’s heel hurt?
The same mechanics that produce heel pain in adults is also found in adolescents. The difference is that kids have an active bone growth center (apophysis) in the back of the heel (calcaneus) which can get irritated.
In an adult, damage will occur in the soft tissue (the plantar fascia). In a growing kid, the same mechanics damage this growth plate. A child’s heel pain will be more generalized around the back and sides of the heel. An adult’s heel pain will be isolated on the bottom and slightly more towards the inside.
The growth center can be compared to a peanut and butter and jelly sandwich. When you squeeze the bread, the PB&J become compressed and push out the side of the sandwich. This is what happens to the growth plate when the Achilles tendon is tight and the foot rolls in. Pronation (excessive rolling of the foot inward while walking) will tighten the plantar fascia and the growth plate gets the same treatment as the PB&J.
An X-ray will show growth plate damage as irregular margins at the back of the calcaneus. It may even look like a mouse has been chewing on the bone. This can easily be misdiagnosed as a fractures by someone not familiar with this problem.
The apophysis will stop growing and disappear at around 12 years for girls and 13 years for boys. The effects of pronation and a tight Achilles tendon will now affect the plantar fascia, as in an adult.
How can you recognize the pain from an inflamed growth plate?
Children may not let you know about their pain and health issues. And that means it’s important for you to know how to tell if your child’s heel hurts.
What you will find is pain around the peripheral area of the heel. A child will have extraordinary discomfort when the back of the heel is bumped on a hard surface. If you want to get your child’s attention, sneaking up and squeezing the back of their heel would be a dastardly yet effective thing to do.
There will also be discomfort at the beginning – as well as the end of – physical activity. There is typically some improvement during exercise.
If your child plays sports, the intensity of symptoms will increase at the end of a season. It does not help when the outdoor playing fields get concrete hard at the end of summer, either. There can be a little improvement between sports but symptoms return with a vengeance when the next activity starts.