Heel pain is a common occurrence amongst children. Sever’s disease or calcaneal apophysitis disease is the most common cause of heel pain in children between the ages of seven and twelve. It is more common in physically active kids and it is described as an inflammatory injury with pain and tenderness on weight bearing on the back/sides of the heel. Recent studies suggest that main contributing factors to the problem appear to be abnormal stress at the growth plate, biomechanical abnormalities of the foot, repetitive impact pressure and shear stress. In some cases the pain can be so intense that children must stop participating in sport activities.
There is a higher occurrence in kids that present with high arched foot, overpronation (feet role inward when walking), shorter leg and kids that are clinically overweight. Sometimes there could be a presence of un-proportional development between long bones and muscles or tendons resulting in the overuse and trauma to the heel.
Signs and Symptoms
One of the most common signs is pain in the back of the heel, extending into the sides and bottom of the foot. A child may also present with swelling and redness in the heel, difficulty walking, discomfort upon awaking, and walking with a limp or on tiptoes to avoid putting pressure on the heel. Symptoms are usually worse during or after activity and get better with rest.
Treatment of Sever’s disease is entirely conservative and our protocols are designed to relieve the discomfort and speed up the recovery. However, before any treatment plan is implemented a detailed physical exam is required. Everything must be taken into consideration including the onset of problems, activity levels, footwear, and all previously attempted treatments. Early intervention will minimize the further injury and allow quick return to athletic activities. We will also make sure to educate the patient about the preventative care and provide guidance on injury prevention techniques. This condition should resolve once the fusion of the growth plates is done but if ignored it can lead to other compensatory foot issues.
If your child is having issues with the heel or foot pain, if they are not recovering in a timely manner or would like a second opinion please contact us for an evaluation.