Pediatric Heel Pain

Chicago Heel Pain Treatment for ChildrenChildren are resilient, but when your child begins to complain about heel pain, this must be taken seriously. Heel pain in a child is not normal. There are different causes of heel pain in a child and an adequate physical exam can help determine which type of heel pain is affecting your child.

What Is Calcaneal Apophysitis?

The most common cause of pediatric heel pain is calcaneal apophysitis (an injury or irritation to the growth plate of the heel). Typically, this occurs in boys between the ages of 8 and 13 who are fairly active children. This is most likely to occur with a rapid increase in activity after a period of rest – such as starting soccer practice in the spring after being off in the winter.

Are There Other Causes of Pediatric Heel Pain?

Yes. Calcaneal apophysitis is the most common cause of pediatric heel pain. However, there are other things that can cause the heels to hurt such as stress fractures, growth plate fractures and hematagenous osteomyelitis, an infection of the heel bone.

Causes of Calcaneal Apophysitis

Causes of pediatric heel pain include:

  • Rapid increase in physical activity (sports)
  • Changes in training surfaces
  • Changes in training techniques
  • Changes in shoe gear (or going barefoot) while being physically active
  • A tight heel cord (Achilles tendon)
  • A rapid increase in growth over a short period of time

During periods of rapid growth, the bones of the leg grow faster than the soft tissues (muscles, tendons and ligaments) and the stress they place across the growth plate can cause pain and inflammation.

Symptoms of Calcaneal Apophysitis

Calcaneal apophysitis typically affects active boys between the ages of 8 and 13; however, this condition can affect any active child. Early signs and symptoms include:

  • Limping
  • Inability to participate in athletic activities
  • Walking on the toes to keep the heel from touching the ground
  • Pain in the heel that is worse after activity and relieved by resting

Diagnosis

Chicago Heel Pain Treatment for Children
Normal calcaneal growth plate indicated
by the arrows.
Your Weil Foot & Ankle Surgeon will start your exam with a thorough history. This will be followed by a physical exam. During your physical exam, your Weil Foot & Ankle Surgeon will look for:

X-rays will be ordered to detect any underlying bone abnormalities. Should your Weil Foot & Ankle Surgeon suspect a cause of your heel pain that requires advanced imaging (such as infection or a stress fracture), he/she will order these tests.

The Weil Foot & Ankle Institute has three extremity MRI’s on site at our Des Plaines, Highland Park, and Lincoln Park locations. These extremity MRI’s only take about 30 minutes for the study and only requires the patient put their foot into a painless machine avoiding the uncomfortable claustrophobia that some MRI devices create.

Treatment

Calcaneal apophysitis can be easily treated with changes in shoe gear, resting, icing, stretching and anti-inflammatory medications. Sometimes, physical therapy may be necessary, but this is rare.

Many times these types of injuries are unavoidable, but proper athletic shoes, stretching exercises and avoidance of obesity are some of the ways one can prevent an injury to the growth plate.

Publications by Weil Foot & Ankle Institute physicians on this topic:

BMI and Calcaneal Apophysitis