DEAR DR. SHARON…….

My son is 10 years old and he has been having heel pain for the past few months. I have noticed that it gets worse when he plays sports and when he is on his feet for a long time. I have tried changing his shoes to give him more support and cushion for his feet, but it has not been helping. I am concerned about his feet and I would like some advice. Why is he getting this heel pain? What can I do help get rid of his heel pain?
Tabatha: Clifton, New Jersey

Dear Tabatha,

Heel pain is very common in children active in sports, especially with children around 8-12 years of age. Around that age, kids have an open growth plate at the heel. The typical age for these “growing pains” at the heel is from ages 8-10 in girls and ages 10-12 in boys. The heel is especially painful in kids who are active in sports such as soccer, and gymnastics where there is continual pounding at the bottom of the foot near the heel. Other sports, such as basketball and football can also elicit the heel pain.

The growth plate, as the illustration shows is at the back of the heel is where your son is most likely getting his pain. When there is injury to the growth plate from constant pressure or trauma to the heel, the heel will become painful and inflamed.

The foot is one of the first parts of the body to grow to its adult size. This usually happens by age 15. At this age, the heel pain will disappear. The bones of the foot therefore, actually grow faster than the muscles and tendons surrounding it. The calf muscle which is attached to the back of the heel may be tight as well and cause the heel to become more painful.

If your child does experience this pain, it is a good idea to go to your medical doctor or podiatrist to have an Xray taken. This Xray will show if there is an open growth plate or if there is a fracture at the heel. If after taking an Xray, you find that your son does have heel pain, your Podiatrist will be able to help you and your son work together to get rid of or to alleviate the pain.

Some of the things that may alleviate your son’s heel pain are as follows.

1. Make sure that he decreases his sports related activities to see if the symptoms will improve.
2. After he is through with his sports at the end of the day, placing ice at the heel is helpful to decrease the swelling and pain.
3. Make sure that your son has a heel cushion in his shoe. Your podiatrist maybe able to give you advice on the type of heel cushion to use. And make sure that he does not walk around barefoot.
4. Try adding a heel raise in the shoe to take the stress of the calf muscle at the back of the heel which may be causing increased pain and stress on the heel.
5. Stretching exercises for your calf muscles may also be helpful for your son to alleviate the pain. Your podiatrist can teach you to do some stretching exercises for the heel.

This type of heel pain is also called Sever’s Disease or Calcaneal Apophysitis. Sever’s Disease is very different from the heel pain that adults experience in their heel. Usually adults have pain due to a stretch in their plantar fascia or tissue which is under the foot, and not due to the heel bone itself. The adult heel pain is called Plantar Fasciitis.