Overview
Heel pain is common in children. While it can occur after a specific injury, it is also commonly caused by Sever's disease, a type of overuse syndrome, like shin splints or Osgood-Schlatter?s disease. Children with Sever's disease, which is also called calcaneal apophysitis, develop inflammation where the Achilles tendon inserts at the calcaneus, or heel bone. This inflammation causes pain, which can vary depending on the type of activity your child is doing, and is generally worse after activity(such as running and jumping) and improves with rest. Sometimes squeezing the heel can cause pain and occasionally it can be felt under the heel.
Causes
Children are at greatest risk of developing Sever's disease when they have reached the early part of a growth spurt in early puberty. For girls, this is typically around ages 8 to 10. For boys, it happens somewhere between the ages of 10 to 12. By the age of 15, the back of the heel has typically stopped growing in most children, and Sever's disease becomes rare. Any running or jumping activities can increase the odds that a child will develop Sever's disease. Soccer and gymnastics are two common sports that tend to put kids at risk.
Symptoms
The pain is at the heel or around the Achilles tendon. This is felt commonly during exercise, particularly activities involving running or jumping. The back of the heel may also be tender to touch and there may be localised swelling. There may be stiffness in the calf muscles first thing in the morning and you may notice limping or a tendency to tiptoe.
Diagnosis
It is not difficult for a doctor to diagnose Sever's disease in a youngster or teenager. A personal history and a physical examination are usually all it takes to determine the cause of heel pain.
Non Surgical Treatment
Initially, Sever?s Disease is treated with rest, anti-inflammatory medication and softer shoes. Ice followed by heat is a common practice and heel cup orthotics have worked wonders for our young patients in the past. It can take anywhere from a few weeks to a year for these growth plates to naturally close - at which point Sever?s Disease disappears. Even though the condition does heal on its own, athletes are encouraged to seek treatment, rather than push through the pain. Simply ?dealing with it? and continuing to play sports despite the injury could lead to an impaired gait, a strained hip or a knee injury. Stretches to strengthen the leg muscles, leg compression wraps and over-the-counter acetaminophen or ibuprofen are also recommended treatments. In very rare cases, a podiatrist may recommend wearing a cast for two to twelve weeks.
Exercise
Stretching exercises can help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should do these stretches 2 or 3 times a day. Each stretch should be held for about 20 seconds. Both legs should be stretched, even if the pain is only in 1 heel. Your child also needs to do exercises to strengthen the muscles on the front of the shin. To do this, your child should sit on the floor, keeping his or her hurt leg straight. One end of a bungee cord or piece of rubber tubing is hooked around a table leg. The other end is hitched around the child's toes. The child then scoots back just far enough to stretch the cord. Next, the child slowly bends the foot toward his or her body. When the child cannot bend the foot any closer, he or she slowly points the foot in the opposite direction (toward the table). This exercise (15 repetitions of "foot curling") should be done about 3 times. The child should do this exercise routine a few times daily.
Heel pain is common in children. While it can occur after a specific injury, it is also commonly caused by Sever's disease, a type of overuse syndrome, like shin splints or Osgood-Schlatter?s disease. Children with Sever's disease, which is also called calcaneal apophysitis, develop inflammation where the Achilles tendon inserts at the calcaneus, or heel bone. This inflammation causes pain, which can vary depending on the type of activity your child is doing, and is generally worse after activity(such as running and jumping) and improves with rest. Sometimes squeezing the heel can cause pain and occasionally it can be felt under the heel.
Causes
Children are at greatest risk of developing Sever's disease when they have reached the early part of a growth spurt in early puberty. For girls, this is typically around ages 8 to 10. For boys, it happens somewhere between the ages of 10 to 12. By the age of 15, the back of the heel has typically stopped growing in most children, and Sever's disease becomes rare. Any running or jumping activities can increase the odds that a child will develop Sever's disease. Soccer and gymnastics are two common sports that tend to put kids at risk.
Symptoms
The pain is at the heel or around the Achilles tendon. This is felt commonly during exercise, particularly activities involving running or jumping. The back of the heel may also be tender to touch and there may be localised swelling. There may be stiffness in the calf muscles first thing in the morning and you may notice limping or a tendency to tiptoe.
Diagnosis
It is not difficult for a doctor to diagnose Sever's disease in a youngster or teenager. A personal history and a physical examination are usually all it takes to determine the cause of heel pain.
Non Surgical Treatment
Initially, Sever?s Disease is treated with rest, anti-inflammatory medication and softer shoes. Ice followed by heat is a common practice and heel cup orthotics have worked wonders for our young patients in the past. It can take anywhere from a few weeks to a year for these growth plates to naturally close - at which point Sever?s Disease disappears. Even though the condition does heal on its own, athletes are encouraged to seek treatment, rather than push through the pain. Simply ?dealing with it? and continuing to play sports despite the injury could lead to an impaired gait, a strained hip or a knee injury. Stretches to strengthen the leg muscles, leg compression wraps and over-the-counter acetaminophen or ibuprofen are also recommended treatments. In very rare cases, a podiatrist may recommend wearing a cast for two to twelve weeks.
Exercise
Stretching exercises can help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should do these stretches 2 or 3 times a day. Each stretch should be held for about 20 seconds. Both legs should be stretched, even if the pain is only in 1 heel. Your child also needs to do exercises to strengthen the muscles on the front of the shin. To do this, your child should sit on the floor, keeping his or her hurt leg straight. One end of a bungee cord or piece of rubber tubing is hooked around a table leg. The other end is hitched around the child's toes. The child then scoots back just far enough to stretch the cord. Next, the child slowly bends the foot toward his or her body. When the child cannot bend the foot any closer, he or she slowly points the foot in the opposite direction (toward the table). This exercise (15 repetitions of "foot curling") should be done about 3 times. The child should do this exercise routine a few times daily.