It’s back to school for kids!  For some, it will also be new sporting seasons, like little league baseball or soccer but for others it will simply be spending more time running and playing outdoors. Regardless of the reason, some children will soon be complaining of…heel pain!
When we are talking about heel pain in children we are not referring to our old friend plantar fasciitis but rather we are referring to calcaneal apophysitis.

Calcaneal apophysitis or Sever’s Disease is a condition affecting the calcaneal growth plate or physis. The condition typically affects children between the ages of 8-14 years. Inflammation of the growth plate is commonly seen in growing children who engage in year-round sporting activities or have increased activity demands leading to increased stress and strain in the heel. The condition is not solely seen in young athletes but can also be seen in children who are overweight, have a tight Achilles tendon, or have foot structure issues like flat feet or high arches.
Calcaneal apophysitis should not be ignored. If your child starts complaining of pain in the back or the bottom of the heel, begins to limp or otherwise is walking differently or has difficulty running or engaging in his or her usual activities, you should seek medical attention. Diagnosing the condition can usually be done with

Calcaneal apophysitis should not be ignored. If your child starts complaining of pain in the back or the bottom of the heel, begins to limp or otherwise is walking differently or has difficulty running or engaging in his or her usual activities, you should seek medical attention. Diagnosing the condition can usually be done with simple questioning of recent activities, a thorough medical history and physical examination by a podiatric physician. X-rays and blood work can be helpful to rule out other causes of heel pain such as fractures or infections but are not always needed.

simple questioning of recent activities, a thorough medical history and physical examination by a podiatric physician. X-rays and blood work can be helpful to rule out other causes of heel pain such as fractures or infections but are not always needed.

Treatment, for the most part, is conservative in nature, consisting of rest, support, and anti-inflammatories. Complete avoidance of activities is typically not required and the standard rule of thumb is as long as the child does not exhibit limping with normal walking, participation in activities may continue. Temporary inserts or custom orthotics are recommended to provide enhanced support to the foot and allow for better healing. Oral medications such as NSAID (non-steroidal anti-inflammatory drugs) such as Ibuprofen help reduce the local inflammation as well as the pain in the area. In more severe cases initiation of physical therapy or even surgery may be required to correct any underlying foot structure issues.

Treatment, for the most part, is conservative in nature, consisting of rest, support, and anti-inflammatories. Complete avoidance of activities is typically not required and the standard rule of thumb is as long as the child does not exhibit limping with normal walking, participation in activities may continue. Temporary inserts or custom orthotics are recommended to provide enhanced support to the foot and allow for better healing. Oral medications such as NSAID (non-steroidal anti-inflammatory drugs) such as Ibuprofen help reduce the local inflammation as well as the pain in the area. In more severe cases initiation of physical therapy or even surgery may be required to correct any underlying foot structure issues.

To avoid this condition in your child, here are some helpful tips to keep in mind. Provide a balanced diet and avoid obesity. Avoid activity that is beyond your child’s ability level. Encourage your child to perform proper stretching and maintain good flexibility. Use proper, supportive shoe wear which is appropriate for your child’s activity. If you suspect your child suffers from a foot structure abnormality, have him or her examined by a podiatrist before the pain starts.