Heel Pain in Children

Adolescents in our greater Cincinnati community have an array of opportunities to learn the values of setting goals, working hard, and being a part of team through the various athletic programs offered by schools and other organizations in the area. Of course, sports (and other physical activities) also do provide opportunities for injuries. Even the most common cause of child heel pain—Sever’s disease—can be exacerbated by running and jumping, even though it is not actually caused by physical activity.

If you’re wondering why your child’s heel is hurting, there are a handful of potential reasons, but Sever’s disease (calcaneal apophysis) is most likely the root cause. At Family Foot & Ankle Center, we provide care for a wide range of lower limb issues, including this one.

Unlike an ankle sprain or stress fracture, the condition is not caused by either an isolated incident or repetitive physical trauma over time. Further, it’s not actually a disease at all! Instead, Sever’s is a condition that develops on account of differences in the physical maturation rates between the Achilles tendon and the heel bone.

The Achilles tendon is an invaluable connective tissue that connects the calf muscle and heel bone. This tendon allows the foot to move up and down as the calf muscle expands and contracts. There is a growth plate (physis) in the back of the heel bone that often goes through a growth spurt before some of the other tissues in the lower limbs, including the Achilles tendon. As a result, the Achilles tugs on the back of the heel bone, which is then the source of your teen’s heel pain.

As noted, Sever’s isn’t caused by activity, but sports featuring lots of running or jumping, like basketball or tennis, can aggravate the condition. This most common ages for patients are 10-15 for boys and 8-13 for girls. Symptoms indicating that your teen might have Sever’s include:

• Heel pain after physical activity, and especially if the pain subsides with rest
• Limping or trouble while walking
• Pain, redness, and swelling
• Tenderness in the affected heel(s), which is particularly noticeable if the area is squeezed gently

The good news is that juvenile heel pain from Sever’s disease will go away once the rest of the tissues in your son or daughter’s feet start to hit physical maturity. Until this happens, however, your adolescent will benefit from treatment centered on alleviating the painful symptoms from the condition.

Whereas Sever’s is the most common cause of heel pain, there are certainly other sources. Less commonly, teens could potentially develop Achilles tendinitis, plantar fasciitis, and heel fractures. These tend to be less common with younger patients because the soft tissues are more limber at that time than they become as we age. A teen’s body is simply better at handling the physical forces that cause overuse injuries in older patients.