Heel pain is a common complaint among children, particularly those who are active and involved in sports. A common cause of heel pain in kids is calcaneal apophysitis, commonly referred to as Sever’s disease.
Sever’s is an overuse injury that can affect one or both heels. It occurs due to repetitive stress on the calcaneal growth plate (also called the epiphyseal plate), the largest growth plate in the foot. This repeated pressure leads to inflammation and pain. Sever’s disease typically develops insidiously, with children experiencing discomfort and pain around the heel that worsens over time and with increased activity.
This condition is most common in children between the ages of 7 and 14, particularly during growth spurts when the bony structures in the heel develop more rapidly than the attached muscles and tendons. Sever’s disease tends to be more prevalent in boys than girls and is more common in children who participate in running, jumping, and pivoting sports.
Pain associated with Sever’s disease is often intensified by tightness and weakness in the calf complex, which pulls on the heel bone. The calf complex consists of the gastrocnemius and soleus muscles, which connect to the heel bone via the Achilles tendon.
Risk factors for developing Sever's Disease:
Rapid increase in load
Eg. After school holidays, start of a new season
Jumping, running and pivoting sports
Muscular weakness
Poor footwear
Hypomobility and hypermobility
Excess pronation / rolling in of the foot
Growth spurt’s
Increased weight and height
Treatment:
Load management - reduce the amount of running, jumping, and sports participation
Stretching and strengthening of the calf and foot muscles
Foam rolling or massage of the muscles and attachments surrounding the heel.
Balance and proprioception training
Education:
Heat application (heat pack or gel) to the calf and heel prior to activity to reduce pain (e.g., Deep Heat).
Ice application after activity or sports.
Warm Epsom salt bath – Epsom salts contain magnesium, which helps to:
Reduce pain and swelling
Increase recovery and performance
Promote sleep
Compression to the calf and heel complex – helps keep the area warm.
Footwear:
Runners are preferred over formal, hard shoes.
Shoes with an increased slope from the forefoot to the hindfoot.
Runners with laces or velcro to secure the foot in position.
If needed, an orthotic insole can be added to support proper biomechanics.
If your child is suffering with heel pain, book in for an assessment at LPSM. We service the areas of Lilydale, Mooroolbark, Mount Evelyn, Chirnside Park, Coldstream and surrounds.