Heel Pain in Children

A common problem seen by podiatrists in active children is heel pain. This condition is commonly referred to as “Growing Pains” and is usually not treated. The most common diagnosis for this is Sever’s Disease. Sever’s Disease is an inflammation of the growth plate located at the back of the heel. This condition is most commonly seen in physically active girls and boys from ages nine to 15 years old. These are the years when the growth plate is still “open,” and has not fused into mature bone. Also, these are the years when the growth plate is most vulnerable to overuse injuries, which are usually caused by sports activities. The most common symptoms of this disease include:
• Heel pain in one or both heels.
• Usually seen in physically active children, especially at the beginning of a new sports season.
The pain is usually experienced at the back of the heel, and includes the following areas:
• The back of the heel (that area which rubs against the back of the shoe).
• The sides of the heel.
Actually, this is one of the diagnostic tests for Sever’s Disease: squeezing the rear portion of the heel from both sides at the same time will produce pain. It is known as the Squeeze Test. The foot is one of the first body parts to grow to full size. During the time of growth, bones grow faster than muscles and tendons. This results in the muscles and tendons becoming tight. The strongest tendon which attaches to the heel is the Achilles Tendon. It attaches to the back of the heel at the site of the growth plate, and during sports activities it pulls with great force on the growth plate. If this pull by the tight Achilles Tendon continues for long periods of time, the growth plate may become inflamed and painful. If exertive activities continue, Sever’s Disease may result. The old adage, “One once of prevention is worth a pound of cure,” is most appropriate when trying to prevent the devastating effects of Sever’s Disease. If this disease is not prevented, or treated in its earliest stages, it may cause the child to stop certain sports activities until the growth plate has fused and matured (this usually occurs around the age of 16 years old). So how do you treat Severs? The first line of approach would be rest, ice, stretching, and a topical or oral type of anti-inflammatory. If the pain persists, then medical intervention is suggested which would include: Custom Molded Orthotics (Insoles), Physical Therapy, Heel Cups or Lifts. While it is true that Sever’s is related to growing pains, the fact is your child can continue to be active and pain free if this condition is treated properly. Why should your child live with pain if they don’t have to?
Dr. Tony Avakian received his medical and surgical training at Cornell Medical Center, Midway Hospital, and Cedars Sinai. He is nationally recognized as one of the top podiatrists in the nation, and has been nominated as the best podiatrist in SCV by KCAL 9 Best of LA.  Visit our Facebook for before and after bunionectomy photos.
For more information, please call Valencia Foot and Ankle Center at 661-288-2321 and visit www.curefeet.com.