Treating Heel Pain in Children

Let's go Footy..!

Well the footy and soccer season’s are upon us, and it is at this time of year that Podiatrist’s tend to see more children present with heel pain.

Heel pain related to activity

Sever’s disease is a common condition in children aged between 8-12 years old.  They normally complain of pain in one or both heels, related to activity.  This is most painful following activity.  Children with Sever’s often run ‘flat footed’ to avoid pushing off when they are sore.

Pain is at the back of the heel, around the site of the growth plate of the heel bone (calcaneus).  This bone fuses at some stage between the ages of 8 and 12 years old, and during this time in active children, the achilles tendon can pull on the attachment to the growth plate, which can inflame and aggravate the area.

Contributing factors related to heel pain

A combination of factors can contribute to the development of the child’s pain, such as:

  • Low ‘heel pitch’ in shoes – shoes that are too flat
  • Tight calf muscles
  • Pronated (rolled in) feet – the calf muscle has to work harder to push off when running, which means there is more force going through the heel

Prevention is definitely the key factor!

If your child is between the ages of 8-12 years old, make sure they are wearing appropriate footwear for their activity, and that you are monitoring their amount of activity, to make sure they are not overloading their young bodies.

The biggest factor that can improve the child’s comfort levels is changing their footwear.  All footwear should have a 10mm ‘gradient’ from the back of the shoe to the front of the shoe. Most running shoes have this heel pitch in them, but football boots do not.

Some children also require orthotics to reduce the rolling in of their feet. 

It is best to have a full biomechanical assessment conducted by a Podiatrist who can advise whether these are necessary and prescribe an appropriate pair.  Typically I use a pre-fabricated device in these children combined with heel lifting.

Dealing with heel pain

Massage and gentle stretching is normally prescribed for the calf muscles.  Ice is essential after all activity, and pain relief or anti-inflammatory gel can be used if necessary.  While the heel is tender, the child’s activity levels need to be reduced.  I obviously like to keep children involved in sport, so this can just be ‘stationary skills’ training during the week, then playing the game on the weekend. If they are still complaining of pain, then please discuss a further reduction in training with the coach, and see a Podiatrist or other health professional.

Hopefully this advice will keep your children out on the track and enjoying a fun and fulfilling footy season!

Nicki Quigley - Podiatrist, Beaumaris Vic