Children are resilient, but when your child begins to complain about heel pain, this must be taken seriously. Heel pain in a child is not normal. The early signs of heel pain include limping, the inability to participate in athletic activities and walking on one’s toes. The most common type of heel pain in a child is called calcaneal apophysitis (an injury to the growth plate in the heel).
Typically, boys between the ages of 8-13 will present with symptoms of pain in the heel and significant limping after participating in athletic activities. However, not always will a child have calcaneal apophysitis, and many times the doctor must rule out a stress fracture.
Causes of Pediatric Heel Pain
The heel pain in a child is typically increased and intensify with physical activity, and many times while being barefoot. The symptoms are typically relieved with protection and wearing cushioned shoes. The cause of this injury is usually seen because children grow rapidly and during these rapid periods of growth, the long bones of the lower leg will grow quicker than the muscles and tendons.
Because the growth plate is an area of weakness until complete development of the calcaneus (heel bone), the added stress of the muscles and tendons along with physical activity can cause inflammation of the growth plate and the subsequent pain.
How to Recognize Heel Pain in Kids
Pediatric heel pain can cause discomfort in the back or bottom of the heel, causing children to limp or walk on their toes to avoid pressure. This pain typically worsens with activity and improves with rest. Affected children may struggle to participate in their usual activities or sports and might experience swelling, redness, or stiffness in the heel area, particularly in the morning.
The heel may be tender when squeezed from both sides, and standing on tiptoes can exacerbate the pain. Children might also find it difficult to wear shoes comfortably. These symptoms can persist for weeks or months, potentially indicating conditions such as Sever's disease, plantar fasciitis, or other foot-related issues. If a child experiences ongoing heel pain, it's crucial to consult a pediatric podiatrist for proper diagnosis and treatment, as the specific symptoms and their severity can vary depending on the underlying cause.
Diagnosis and Treatment Explained By Our Albuquerque Podiatrist
Because of the challenge of making a diagnosis for the cause of the heel pain, it is most important to see a foot and ankle surgeon. The foot and ankle surgeon will take a complete medical history, perform a thorough examination and order the appropriate diagnostic tests, which may include x-rays, bone scans or an MRI. New Mexico Foot and Ankle Institute has an in-house MRI for immediate results.
There are numerous treatment options for pediatric heel pain and the treatment will be determined by the foot and ankle surgeon after the examination.
Treatment for children's heel pain often begins with rest and activity modification to reduce stress on the affected area. Applying ice to the heel can help reduce inflammation and pain. Stretching exercises, particularly for the calf muscles and plantar fascia, are often recommended to improve flexibility and reduce tension. In many cases, supportive footwear with good cushioning and arch support is crucial; custom orthotics or heel cups may be prescribed for additional support. Over-the-counter pain relievers like ibuprofen can help manage pain and inflammation.
Physical therapy may be beneficial, focusing on strengthening exercises and techniques to improve foot mechanics. In some cases, night splints or casting might be used to maintain a stretching position during sleep. For severe or persistent cases, our Albuquerque podiatrist might recommend more advanced treatments such as shockwave therapy or, rarely, corticosteroid injections.
It's important to note that treatment plans should be individualized, and parents should work closely with a pediatric foot specialist to ensure the most effective and appropriate care for their child's specific condition.
