Heel Pain in Children

What is Heel Pain in Children?

Heel pain in children (Calcaneal Apophysitis), also known as Sever’s Disease, is a common overuse injury in physically active children. The term ‘calcaneal’ refers to the heel and apophysitis means an inflammation of the growth plate. The growth plate is area of new bone growth and is made up of cartilage. It’s located at the back of the heel and is very susceptible to injury as it is weaker than the solid bone. It is sensitive to high impact physical activities such as running and jumping, and repetitive pulling stress from the Achilles tendon. This results in painful inflammation of the heel. Other factors that may contribute to the inflammation are poor footwear, tight calf muscles, growth spurt and foot posture e.g flatfoot or a high-arched foot.


Who is affected by it?

Calcaneal Apophysitis is most common in active children between the age of 7-15 years in boys and 5-13 in girls. Boys are more likely to be affected than girls.


What does it feel like?

  • Pain in the back of one or both of the heels.

  • Swelling, tenderness and redness around the heel.

  • Pain during and after physical activities that require running or jumping.

  • Limping and tendency to tiptoe to avoid pressure at the heel.

How can podiatrists help?

  • Modification of certain activities and training load that directly cause the pain.

  • Stretching and strengthening exercise program for the calf muscles.

  • Use of heel raises to reduce the tension of the Achilles tendon on the growth plate.

  • Orthotics therapy to address any lower limb biomechanics that contribute to the pain.

  • Educate and provide guidance on specific footwear that suit certain foot posture and activities.

  • Reduce the inflammation process with cold therapy.