Why Do My Child’s Heels Hurt?
The first thing to understand is that heel pain in kids, especially adolescents and “tweens,” is usually not caused by the same mechanical processes as adult heel pain.
Although kids can get more adult-like wear-and-tear injuries like plantar fasciitis or Achilles tendinitis, they are much more likely to be suffering from a condition that only appears in childhood—Sever’s disease, also known as calcaneal apophysitis.
Don’t let the word “disease” scare you. It is not a true disease. As with most other forms of heel pain (in both kids and adults), Sever’s is generally considered an overuse injury.
During this phase of life, the bones are growing rapidly. In order to achieve this growth, the ends of many bones (including the heel bone) are “capped” by a region of tissue called an epiphyseal plate, also known as a growth plate. This plate is softer than the harder, more mature surrounding bone, and thus more prone to irritation and injury.
“Sever’s disease” is simply the name we give to injuries affecting the growth plate of the heel, which is especially exposed and vulnerable. Common triggers and risk factors may include:
- Increase in physical activity (running, sports, etc.), in terms of intensity, frequency, or both. Youth athletes playing sports with a lot of running and jumping are especially vulnerable.
- Wearing shoes with poor support or cushioning.
- Having certain foot structures or postures, such as flat arches.
- Growth spurts in which the growth of the heel outpaces that of the muscles and tendons that attach to it. (Tight calf muscles or Achilles tendons can painfully tug on the heel.)
- Being overweight, obese, or simply having a very high BMI.
How Worried Should I Be About My Child’s Heel Pain?
First things first: If your child is experiencing significant heel pain, you should always bring them in to see Dr. Patel. There’s always a risk that the condition will worsen, or might actually be something other than Sever’s disease. We definitely want to make a complete evaluation and give you our personalized recommendations.
That being said, the good news is most cases of Sever’s disease are self-limiting and can usually be addressed through conservative care strategies undertaken at home. Typical episodes rarely last more than 1-2 weeks if they are managed appropriately. And of course, once the heel bone reaches full size and maturity (usually early-to-middle teens in girls and middle-to-late teens in boys), the growth plate closes into hard bone.
However, during those vulnerable adolescent years, Sever’s disease can continue to recur several times, especially if your child doesn’t take the appropriate steps to manage and prevent it. And chronic, untreated Sever’s disease can occasionally develop into more serious or longer-term issues.
So while it’s definitely not time to panic, this is a problem that you should take seriously. It’ll spare your teen a lot of pain in the long run, and help them build healthy habits and enjoy their activities!