A common cause of heel pain in children

Heel pain is as common in children as it is in adults, except the cause of heel pain for most children is due to inflammation of the growing bone of the heel. This inflammatory condition is known as Sever’s disease or Calcaneal Apophysitis.

Sever’s disease is characterized by pain in the heel caused by inflammation of the calcaneal physis or growing heel bone. The heel bone becomes inflamed in an area in which growth is still occurring called the physis. The physis becomes inflamed due to excessive pulling of the Achilles tendon.  Most physicians agree that the heel pain in Sever’s disease is due to micro-trauma in the growing heel bone due to over pulling of the Achilles tendon; however, the absolute cause of Sever’s disease is unknown.

Sever’s disease is considered to be an overuse-disease in children between the ages of 8 – 12 years old. Symptoms are most common in active or overweight children, especially in children who play soccer, participate in gymnastics, or any activities that requires excess running or jumping. Commonly, children who play soccer develop Sever’s disease because of their footwear or soccer cleats. Most soccer cleats have negative heels, which will increase stress in the region where the Achilles tendon inserts onto the heel.

Sever’s disease can occur in one or both heels. Clinically, children with Sever’s disease will have no swelling or redness, but instead will have extreme tenderness on the back of their heel, especially when squeezed and causes heel pain in children. It can be easily treated with simple heel lifts in a child’s shoe or with rest, ice, and pain medication. However, in extreme cases it is necessary to immobilize the whole foot in a cast for a week or two for proper healing of the inflamed bone. If you think your child has Sever’s disease see a podiatrist. For more information on heel pain and other foot related issues, please visit our website.