There are many different causes of pain in the bottom of the heel. In the pediatric population, between the ages of nine to 12, the most common cause is calcaneal apophysitis. This condition is an acute inflammation of the growth plate at the back of the heel bone, also known as the calcaneus. This is usually not caused by a sudden injury; rather, it is a gradually developing condition often associated with sports programs. Sports requiring running, sprinting, sudden stopping and starting and changes of direction can contribute to the development of calcaneal apophysitis.
Underlying tightness in the Achilles tendon is a common finding in the kids who develop this type of heel pain. Because of this, we recommend all kids in regular sports and exercise programs, such as football, gymnastics, soccer, and such, pay special attention to stretching the Achilles tendon. These stretches are important before and after the practice, workout, or game. We also see this condition develop in kids who have flattened arches. The reason this is a contributing factor is that with pronation and flattening of the arch, the heel bone, or calcaneus, undergoes more rotation with each step. This can lead to the development of stress and inflammation of the growth plate.
Treatment usually requires a brief one to two week cessation of activity to allow the inflammation to subside. Immobilization in a cast, boot, or brace is often helpful to speed the recovery. This is usually followed by a stretching program, a review of appropriate shoes and consideration for better arch supports. Custom orthotics are sometimes recommended as well. If your child is around nine to 12 years old and begins complaining of heel pain, early recognition of the problem will help lead to a quicker overall recovery period. At-home treatment initially should include a few days of rest, icing and stretching. If the pain persists, it’s likely time to visit your doctor.
New patients and referrals are welcome at the Foot & Ankle Institute of Valencia. Please call 661-260-1180 for an appointment.