Heel pain in Children

Heel pain is one of the most common conditions that we see here at Advanced Foot and Ankle in McKinney and Prosper, Texas. Many of our heel pain patients are children. Now, pain in the heel is not normal. It is your body's way of saying to you, "hey, I am not feeling very well down here!" With that being said, pediatric heel pain should not be ignored.

Your child often will complain of pain along the back and/or bottom of the heel or heels and you may see him or her limping or walking on their toes. Often times the heel pain is present during and/or after activity.

The most common cause of pediatric heel pain is a condition called "Calcaneal Apophysitis" or "Sever's Disease." This typically effects kids between the ages of 8-14 years old. This is not the only cause of pediatric heel pain. Other causes can be a fracture, contusion, infection, warts, callouses and in rare cases a tumor.

Pediatric heel pain does differ from heel pain seen in adults. Heel pain seen in adults is often "Plantar Fasciitis" which is a condition that causes inflammation of a long ligament called the Plantar Fascia that runs from the heel bone to the soft tissues behind the toes. Plantar fascia pain is worse after rest (in the morning after rising from bed or after sitting for a while). In the case of Pediatric Heel pain, the pain often increases with activity such as walking and playing sports. Heel pain in kids is common due to the fact that the heel is still growing. The heel bone is not fully developed until the child is 14. There is a growth plate (called the apophysis) along the back of the heel. If the the apophysis is stressed, heel pain will begin due to inflammation. The Achilles tendon inserts along the back of the heel behind this growth plate, and because of this, its aggressive pull on the heel often irritate the growth plate.

It is important to seek treatment at Advanced Foot and Ankle in McKinney and Prosper, Texas for pediatric heel pain since there are more than once cause of pediatric heel pain. Causes include Calcaneal Apophystitis as discussed, Tendo-Achilles bursitis which is a condition in which a sac of fluid between the achilles tendon and the heel bone becomes inflamed. Causes of bursitis can be inflammatory conditions such as arthritis, poor footwear or trauma.

Overuse syndromes can also cause pediatric heel pain. Overuse syndromes typically are seen in kids older than 14 years old. They may suffer from tendinitis of the Achilles Tendon, or less common, plantar fasciitis.

Fractures of the heel can also be seen in kids. Stress fractures are small hairline fractures that are seen more often in teenagers that are active in athletics. Stress fractures are often associated with increased activity. Acute fractures are seen as a result of trauma such as jumping off a piece of furniture, stairway, fence or roof. Heel fractures can be very serious and medical attention should be sought out immediately.

Treatment of pediatric heel pain is often initiated by seeing one of the Podiatrists at Advanced Foot and Ankle. A thorough extremity exam will be carried out follow by X-rays. Sometimes a MRI or CT scan may be necessary. Blood work may also need to be order to rule out arthritic inflammatory conditions or if an infection is suspected.

Treatment depends on the diagnosis and the intensity of the pain. Rest or reduced activity is often suggested. Our doctors may suggest that the child refrain from high impact activity including running and/or jumping. Heel lifts, night splints and/or walking cast immobilization may also be entertained as treatment options. Anti inflammatory medications, physical therapy and custom molded foot braces (orthotics) are other ways of treating pediatric heel pain. On rare occasions surgery may be needed, especially if the child has a short heel cord.

Can anything be done to prevent pediatric heel pain? Yes, shoe gear such as avoiding cleated shoes, avoiding obesity, choosing well constructed shoes that coincide with the patients activity and avoiding activity that may be too aggressive for the child's physical ability.

Dr. Eric Silvers and Dr. Kory Williams see pediatric heel pain daily and are well trained to treat all foot and ankle conditions seen in children. They can be reached at 972-542-2155 or you may visit our website at http://www.advancedfoottexas.com/ .

Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155