There are 26 bones in the feet and they continue to grow until the mid to late teenage years. This means that until fully formed, there are delicate growth plates in the foot bones of a child and adolescent.
Sometimes there is inflammation surrounding the growth plate and this would be called an apophysitis. When it happens in the heel bone (the most common presentation in the foot), we call it Sever’s Disease.
Causes of heel pain
Typically, we see this occur in active children; girls (aged 8-10) and boys (aged 10-13). The cause is believed to be repetitive trauma to the heel growth plate, which is already under stress from the pull of a strong ligament (the Plantar Fascia) and an even stronger tendon (the Achilles Tendon). The repetitive trauma is usually due to high impact sports, such as basketball, football, rugby, long jump, gymnastics, dance and so on. It is also related to certain biomechanical foot types. These foot types often have some type of abnormal alignment. When alignment is off, the foot moves through walking, running or landing a jump differently than those which are in better alignment, causing it to be more susceptible to injury. Our lower limb clinicians will determine if your child’s heel pain is in fact due to inflammation surrounding the growth plate or if further studies are needed, such as an x-ray to rule out other possible causes of pain.
What to expect at BioPed
When a child presents to the clinic with complaints of foot pain, we don’t simply dismiss this as “growing pains” or “normal.” In fact, children should not have foot pain. We take this complaint very seriously. At their BioPed appointment, children can expect to be asked to kick their shoes and socks off and expose their legs up to just above their knees. Our foot lower limb clinicians will carefully examine their feet, paying attention to structure, alignment and joint range of motion. They will then observe the child standing and walking. They may also take some measurements of their leg length or joint movement. In total, this type of an assessment typically takes 45 minutes. At the conclusion of the exam, the BioPed clinicians will offer some insight into what the culprit for the pain is and how it can be corrected. They may recommend that the family doctor order additional testing based on their findings also.
Treatment for heel pain
Treatment is aimed at identifying the cause for the heel pain and offering a solution. If the child is experiencing Sever’s Disease (an inflammation of the heel growth plate), our goal is to ensure healing of the growth plate, and identification of the root cause, in addition to relieving the child’s pain. Our lower limb clinicians will communicate a plan that is best suited to your child’s needs. The treatment may include any of the following – temporary reduction in physical activity, bracing, custom or over-the-counter orthotics, footwear recommendations, icing, heel cups, physical therapy or otherwise. It is best to seek professional treatment to avoid any long-term repercussions.
