Though heel pain is more common in adults, children and adolescents may also complain of it from time to time.
Often when a child complains of heel pain it is thought to be “growing pains”, a natural occurrence during growth spurts. Growing pains are a minor, short-lived pain, usually in the legs, where the muscle attaches to the bone. During a growth spurt, the bone will sometimes grow faster than the muscle which results in a muscle or tendon strain that causes some mild pain or discomfort. The pains usually occur late in the day or at night, after a day full of activity.
This could be the cause of your child’s heel pain, however, there are other possible causes of heel pain in children and adolescents.
Common Causes of Heel Pain in Children
Achilles tendonitis is caused by a strain on the Achilles tendon. It is usually caused by an increase in activity or a tightness of the calf muscles (often experienced in growth spurts). The tendon will be painful during activities such as running and jumping, and there is often pain and stiffness in the morning.
Bursitis is an inflammation of a bursa (a pocket of fluid adjacent to the tendon) that is caused by tendon strain or an irritation of the tendon from rubbing against tight shoes. It can cause pain and swelling in the area near where the Achilles tendon attaches to the heel bone.
The calcaneus, or heel bone, has an area where bone growth occurs, known as apophysis. This happens at the back of the heel bone where the Achilles tendon attaches. This growth plate can cause pulling and tension of the tendon, which can lead to a painful heel. This condition, also called Sever’s disease, typically occurs between the ages of 7 and 14. Increased activity, such as jumping or sprinting can aggravate the condition, especially if strain has been placed on the Achilles tendon.
If the pain is located on the bottom of the heel, it could be a condition known as plantar fasciitis. It is caused by inflammation on the underside of the heel bone, where the plantar fascia (a band of connective tissue) attaches. The condition can be caused or aggravated by foot function problems such as flat feet or high arches. Children will often complain of this heel pain the most in the morning or after activity.
Treatment of Common Heel Pain in Children
The common factor between the above conditions is that they are caused by physical stress on the foot. If your child is experiencing pain, bring them in to Rocky Mountain Foot and Ankle for a diagnosis. Once a diagnosis has been made we can work on a treatment plan that best benefits your child. Often, treatment will include rest and daily stretching of the feet and ankles. Occasionally physical therapy will be recommended to improve strength and flexibility. If there are structural or functional problems with your child’s feet that are contributing to the heel pain, shoe orthotics may be recommended. Sometimes the use of an ankle brace or support may be prescribed.
Less Common Causes of Heel Pain in Children
The following are more serious, yet less common conditions that can cause pain in the heels.
- Bone fractures
- Congenital bone fusions, known as tarsal coalitions
- Tumors or bone cysts- rare causes of heel pain diagnosed by x-ray or other imaging studies
- Ulcerative colitis and Crohn’s disease
- Various inflammatory conditions like juvenile rheumatoid arthritis and juvenile spondyloarthropathies such as reactive arthritis, psoriatic arthritis, and ankylosing spondylitis, can cause pain in the heels.
If there is no improvement with the treatment of the common causes of heel pain, make sure to let the doctor know so there can be further evaluation and to rule out one of the more serious causes.
Feet shouldn’t hurt, and neither should their treatment. If your child is experiencing heel pain, then give us a call. Our foot and ankle care doctors and surgeons are board-certified by the American Board of Foot and Ankle Surgery and are members of the American College of Foot and Ankle Surgeons and the American Podiatric Medical Association. Call (208) 855-5955 or request an appointment online.