At my kids' morning bus stop yesterday the topic of conversation turned to kids heel pain. A number of kids on several different soccer teams are currently sidelined with heel pain. In one case, there were as many as 5 kids who were currently suffering from heel pain from just one soccer team. So what is this very common problem in children and adolescents, and how do you prevent this from occurring in your child.
Heel pain in children occurs when there is a microtrauma at the growth plate, which is located at the back of the heel bone. This condition is called Sever's disease or calcaneal apophysitis. This mostly commonly occurs between the ages of 7 and 15, your typical active child or teenager. The achilles tendon attaches to the growth plate of the heel. If the tendon is short (a tight heel cord), it places the growth plate under tremendous tension and causes an inflammation between the growth plate and main portion of the heel bone. The symptoms include pain while running or playing sport, pain when the heel is squeezed, and/or pain when the back of the heel is palpated. Although it can occur with any sports, soccer or sports where cleats are worn are most commonly affected. Cleats offer very little support and can often cause increased motion at the heel which can worsen the inflammation at the growth plate interface.
Treatments include rest, ice, compression and elevation (RICE) and stretching. By stretching out a tight achilles, you reduce the amount of traction placed on the growth plate. If the pain is moderate, a podiatric physician may prescribe heel lifts which will temporarily reduce the traction at the growth plate by shortening the achilles tendon. Orthotics can be placed in cleats to reduce the motion at the heel. In cases the pain is severe, the patient may be immobilized to prevent any motion or pushing off to reduce inflammation and help stretch out the achilles tendon.
To prevent Sever's disease from developing, keep the hamstrings and achilles tendons stretched out! Wear supportive shoes and consider getting an insole in the cleats. Don't allow pain to sideline your child. And remember to see your podiatrist if symptoms or pain persists.
Dr. "Sandie" Grulke
http://www.podiatrycarespecialists.com/
