Heel pain is one of the most common complaints patients usually have. The pediatric population is no different. The adult population generally complains of heel pain secondary to inflammation of the medial plantar fascia band.In pediatrics, it is almost always due to inflammation at the apophysis.
The apophysis is a secondary ossification center that is present in the body during the growing period. It is a cartilage ring that is placed within the heel bone. It maintained its cartilaginous status until about the age of 15. Until that age, active kids experience heel pain, some more often others.
The pain is due to the pulling of the Achilles tendon from its attachment to the posterior aspect of the calcaneus. Whenever the pulling occurs, the Achilles moves the posterior aspect of the calcaneus upward and causes micro motion at the area of contact between the posterior calcaneus and the cartilaginous ring. The pain can be frustrating in very athletic or active kids. They tend to weight bear on the forefoot to prevent aggravation to the painful area.

The treatments are usually directed to symptoms reliefs instead of a definitive treatment, and they are based on the level of pain. Among the treatments that the healthcare professionals will use are: heel lift, anti-inflammatory, and RICE.

Placement of a heel lift in the patient’s shoe will decrease the power of the Achilles tendon and therefore decrease the motion that occurs in the heel.

Anti-inflammatory, like Motrin, tends to decrease the swelling and pain at the area.

RICE stands for: Rest, Ice, Compression, and elevation. It is, sometimes, very hard to keep an active child off his or her enjoyable activities. But when the physician is successful at convincing the child to stay off of his or activities that usually brings relief to the painful area. The hardest thing to achieve is preventing the pain from coming back. It tends to reoccur until the heel bone is fully matured.

They are many other reasons why kids haveĀ heel pain, but none as common as inflammation of the apophysis or apophysitis. That ailment should be aggressively treated by specialists and the cause should be identified before formulating a final treatment plan.

Job Timeny, DPM
Fellowship Trained
in Limb Lengthening and Limb Deformity Correction
Foot and Ankle Surgeon
Elite Foot & Ankle Specialists, LLC
Fort Myers, Florida