Pediatric Orthopedics: Children’s Heel Pain

by admin on June 6, 2012

It’s the time of year that we see a spike in the number of kids (particularly adolescents) complaining of pain in the heels.  In the early 20th century, there was a relatively common condition called “spring heel” which was a type of bone infection that happened in the cold wet of spring as a result of pneumonia or other upper respiratory infection.  With the advent of antibiotics and better pediatric care, spring heel, and the frequency of springtime heel pain, became very rare.  In modern times, however, we see a lot of kids complaining of heel pain in the springtime again, but the cause is entirely different.
Calcaneal apophysitis (also called Sever’s disease) is a type of stress fracture affecting the growth plate of the heel bone in children between the ages of 11 – 13 (although it can affect almost any age that a child is still growing.)  Sports are usually the culprit, particularly high-impact activities like soccer and football…this is the reason it happens in the spring, when kids cooped up all winter finally get to play sports outside.  The pain is in the bottom and back of the heel, and is worse with activity, worst at the end of the day.  It usually responds to antiinflammatories (Advil, Aleve) but not to ice.  It can be so severe the child has to quit the sport or activity that caused it.  But not for long.
Apophysitis, fortunately, is easily treated with in-shoe orthotic devices that allow the child to continue to participate in sports and recreation without risk of further injury.  Usually with treatment the problem resolves in 2-3 weeks, although in some more severe cases a cast is required.  It is important to make sure that when a child has heel pain, the right diagnosis is made.  Other causes of heel pain in children include fracture, plantar fasciitis, tendonitis, and of course, spring heel.  The diagnosis is usually made with an X-ray to rule out the other possible causes.  Talk with your pediatrician, podiatrist, or pediatric orthopedic surgeon for more information.

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