We are seeing more children presenting with heel pain this year due to a decrease in organised sport in 2020. Even if your kids have been active during this time, their tolerance to the movements of sport will have decreased.
The most common type of Heel pain in children and adolescents is known as “Sever’s Disease”. It typically presents in kids aged 8 to 14 years old and is more common in males.
What is it?
Sever’s Disease, technically known as “Calcaneal Apophysitis”, is inflammation of the growth plate at the heel (calcaneus). The calcaneus is not fully developed until approximately 14-15yrs old in girls and 15-16yrs old in boys. The growth plate is made up of cartilage and is more prone to injury due the tissue being weaker than the surrounding bone.
Children will generally experience increased pain with activities such as sport, running and jumping and will settle with rest.
What is causing it?
Heel pain is a result of two factors:
- The discomfort will generally follow a growth spurt. The bones elongate which results in the muscles and tendons in the legs becoming tighter, which increases friction at the heel.
- Heel pain is more common in active kids who play sports that involve movements such as running, jumping and changing direction. This repetitive movement causes increased stress on the growth plate which leads to inflammation and pain.
What can be done?
- Stable and cushioned shoes for both exercise and everyday/school
- Shoes with a higher heel pitch will help off-load the growth plate / achilles tendon
- Ensure footwear is appropriate for activity and individual foot type
- Maximise time in shoes and avoiding being barefoot
- We recommend going to a specialty footwear store to be fitted to take out the guesswork. Our favourite is Active Feet in Geelong and Ocean Grove
Flexible Inserts and Heel lifts
- There may be a biomechanical inefficiency that is contributing to the pain, which will need to be addressed
- Flexible orthotic devices may be indicated
- The additional of heel lifts will also help reduce symptoms in the short term
Strength and Mobility
- Soft tissue treatment and Massage is recommended to release tightness within the calf muscles while it is adapting to growth
- Increasing strength in the calf and further up the chain will help control foot movement and increase shock absorption.
- A simple starting exercise “Isometric calf raise”
- Rise up onto the balls of your feet barefoot (about ¾ max height), ensure you are putting weight through your big toe joint. Hold for 20 seconds and repeat 5 times, once per day.
Any questions please let us know! We’d love to help.