A common cause of heel pain in young athletes is called calcaneal apophysitis. This condition is also known as severs disease or “growing pains”. Calcaneal apophysitis is inflammation of the growth plate in the calcaneus (heel bone). Generally the heel pain is activity related and is worse after increased activity. You might notice a limp after activity or the patient will complain of pain after activity. Calcaneal apophysitis is caused by microtrauma from the pull of the Achilles tendon and overuse of the associated bones, tendons, and growth plate. This microtrauma causes the growth plate to become inflamed and therefore cause pain.
Signs and Symptoms:
- Pain in the back or bottom of the heel
- Walking on toes
- Difficulty running, jumping, or participating in usual activities or sports
- Pain with side to side compression of the heel
- Reduce activity - The child needs to modify any activity that causes pain.
- Support the heel - Temporary shoe inserts like gel heel cups or custom orthotic devices may provide support for the heel.
- Icing - Ice the area after activity.
- Stretching - Stretch the appropriate muscles.
- Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.
- Physical therapy - Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue.
- Immobilization - In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile
- Maintain good flexibility through stretching exercises
- Avoid excessive running on hard surfaces
- Appropriate shoe gear with supportive, shock absorbent sole