by Mark Birmingham, DPM
Podiatry Specialist at Boulder Medical Center
Indoors and outdoors, youth athletes stay active year around in competitive sports, and for many of them heel pain has become “just another part of the game.” The foot and ankle physicians at Boulder Medical Center advise that when a child complains of heel pain, it should be diagnosed promptly because it may be a warning sign of a serious foot problem.
As children become more active in sports they increase their risk for growth plate injuries and subsequent heel pain. Heel pain occurs frequently in children ages 6 to 14 as their feet grow and the heel bone develops. This condition is called Sever’s disease or Calcaneal Apophysitis. With Calcaneal Apophysitis, bone forms in an area behind the heel, known as the growth plate, and cartilage is vulnerable to severe inflammation from strain or stress. With repeated stresses and strains from over-activity, the heel becomes painful.
Even though growth plate trauma is the leading cause of heel pain in young people, the condition can be difficult to diagnose. We caution that parents should be concerned if a child has pain in the back or bottom of the heel, limps, walks on the toes, or seems to have difficulty participating in normal recreational activities. The condition is diagnosed by a thorough examination of the child’s feet and legs and possibly medical imaging tests to rule out other serious causes of heel pain, such as bursitis, tendonitis and fractures.
In most cases, mild or moderate heel pain can be treated successfully with shoe inserts to soften the impact on the heel, anti-inflammatory medications, stretching and physical therapy. In severe cases, the foot and ankle will be immobilized in a cast and, in rare instances, surgery may be necessary.
Heel pain in young people often returns after treatment because the growth plate is still forming until the age of 14 or 15. However, the risk for recurrence can be lowered by choosing well-constructed shoes with good support and restricting use of spiked athletic shoes, especially on hard fields. It also is advised that young athletes avoid competition that exceeds their physical abilities.
About Mark Birmingham, BPM
Dr. Mark Birmingham specializes in the medical and surgical treatment of the foot and ankle. As a devoted patient advocate he believes that quality patient education and training improve treatment outcomes and contribute to success in returning to activity. Aside from patient care, Dr. Birmingham enjoys running, hiking, traveling and keeping current on health and nutrition. He and his wife have the privilege of raising their four small children.