Heel Pain in Children: Symptoms, Causes, and Treatment

February 23, 2009

Symptoms of Heel Pain in Children

Pediatric heel pain is a warning sign that a child has a foot condition that needs to be evaluated. Heel pain problems in children are often associated with the following symptoms:

  • Difficulty participating in physical activities or sports
  • Pain in the back or bottom of the heel
  • Walking on toes
  • Limping

Typically, the child will complain of pain in one or both heels with running and walking. The pain is localized to the point of the heel where the Achilles tendon meets the calcaneus (heel bone), and causes tenderness an pressure at that site. Walking on tip-toes often relieves the pain.

Heel Pain in Children: Common Causes

A common cause of heel pain in children is a condition called calcaneal apophysitis, usually affecting 8 to 14-year olds. Sometimes pediatric heel pain may be a sign of other problems, and may occur at a younger age.

Heel pain is common among children because of the very nature of their growing feet. In children, the heel bone (the calcaneus) is not yet fully developed until age 14 or older.  Until then, new bone is forming at the growth plate (the apophysis), a weak area located at the back of the heel. Repetitive stress on the growth plate (due to walking, running and sports) causes inflammation in the heel area.

Calcaneal apophysitis is also known as Sever’s Disease, and is the most common cause of heel pain in children. This condition usually causes pain and tenderness in the back and bottom of the heel when walking, and the heel is painful when touched.  It can occur in one or both feet. Because the heel’s growth plate is sensitive to repeated running and pounding on hard surfaces, pediatric heel pain often reflects high activity. Children and adolescents involved in football, soccer, track, or basketball are especially vulnerable.

Overpronation, which involves rolling inwards of the feet due to flat feet or fallen arches, increases the stress on the growth plate, and is therefore a major contributing factor to pediatric heel pain.

Pediatric Heel Pain vs. Adult Heel Pain:  What’s the Difference?

Heel pain in children differs from the most common form of heel pain experienced by adults (Plantar Fasciitis) in the way pain occurs. Plantar Fasciitis pain in adults is worse when getting out of bed in the morning or after sitting for long periods, and then it subsides after walking around a bit.  Pediatric heel pain usually doesn’t improve in this manner. In fact, walking around typically makes the pain worse.

Treatment and Relief of Heel Pain in ChildrenDepending on the severity of the pain and the diagnosos, there a number of treatment options, including:

  • Reduce physical activity. The child should reduce or stop any activity that causes heel or foot pain.
  • Medications. Anti-inflammatory drugs, such as ibuprofen, help reduce pain and inflammation.
  • Reduce the stress on the plantar fascia by performing foot stretching exercises often help
  • Orthotic insoles. Orthotics will help support the foot properly and prevent over-pronation, the main cause of pediatric heel pain.

If your child’s heel pain persists, it is recommended that you consult a Podiatrist.


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