Does Your Child Complain Of Heel Pain?

My son limps, doesn't play, complains of heel pain. What can happen to my son?

This is a very common phrase in consultation when a parent comes with a child, who has always been a very active child and lately only complains of heel pain and does not want to walk or does not support the heel. Heel pain in children is one of the most common pediatric complaints we see.

At Podologia Priego we see patients of all ages. It is important to have a clinical review of a child from birth and during his or her growth. Our public health system will provide these check-ups free of charge by your pediatrician. Even so, it is good that a multidisciplinary team works together.

It is rare for a child to present a pain in the heel when his age is less than 7 years, because the own plantar fat of the child that in these ages is with much thickness is going to manage to cushion the bony zone of the calcaneus. But... What happens when the child begins to form the morphology of the foot and the plantar fat decreases?

A high percentage of patients between 9 and 13 years of age come to the clinic because they report pain in their heels that prevents them from exercising and in some cases can even limit their walking. This is a condition called Sever's disease. In very active children, it is not uncommon for heel pain to develop as they grow older. The reason for this is the inflammation of a thin, cartilaginous joint growth line in the heel bone (calcaneus), which is in that age period divided into two cores. The back of the calcaneus is attached to the Achilles tendon, located at the back of the leg/foot. The anterior is attached to the plantar fascia. 

This inflammation can be due to two reasons, when children are very active, the Achilles tendon pulls on an area of the bone area where growth plate is present, and this creates an irritation on the growth plate, and therefore pain. The other reason is micro-traumatism in the plantar area located under the growth plate, due to jumping, very flat shoes with very hard soles, or even worn out shoes. This pain can have a sudden onset and can be very painful. 

Treatments for Sever's disease vary depending on the patient, however, a general principle is anti-inflammatory, ice, stretching, and most importantly, support. 

1. Stretching helps remove some of the stress from the Achilles tendon and therefore limits the stress on the growth plate.
2. Focusing on the etiology and type of support will be the key to success. To do this we will assess within the biomechanical study of walking the type of footwear used by the child. Custom-molded orthoses are the most effective way to achieve cushioning and correction, because they are custom-made for your child's feet. Customized plantar orthoses not only cushion, but support and limit movement in the heel, which in turn resolves pain once and for all. Whether your child is a dancer in flat shoes or a soccer player in cleats, we can design a custom orthosis to fit your child's shoes and provide maximum support and relief.