Sports Medicine: Heel Pain in the Young Athlete

 Pediatric heel painEarlier this year I wrote about a number of possible causes for heel pain in the adult. The pain, of course, constitutes a helpful signal alerting you that something is wrong and maybe where the problem is in the foot. Among the lesser known causes of heel pain is calcaneal apophysitis – injury to the heel growth plate. The common term used to identify calcaneal apophysitis is “Sever’s disease.” Sever’s disease is common in boys between the ages of 9 to 14, and in girls 10 to 13. In most cases, sports is the aggravating factor; particularly running, jumping, jarring sports such as football, field hockey, and soccer. The fact that youngsters are still growing and developing their bones, renders them more susceptible to this problem. Reports of heel pain usually start arriving in early fall when school sports begin their new season. An individual’s pain may stop after rest but return once activity resumes. Common symptoms also include a limp and an irritation in the heel.

Some people may dismiss Sever’s disease as a type of “growing pain” that the adolescent will outgrow. Coaches and parents have to be sensitive to the “growing pains,” especially in the athlete. A muscle imbalance may be disposing a pre-teenager to Sever’s disease. Also, since a heel injury can be aggravated by wear and tear, coaches and parents should consider limiting an afflicted child’s sports activity. There may be a mechanical problem with the feet for example, if the adolescent’s foot rolls in while walking (pronation), an orthotic device may be needed to relieve stress on the Achilles tendon. An orthotic is a custom designed,individually fitted device placed in the shoe to change foot function, thereby controlling or eliminating factors that may lead to foot and lower extremity malfunctions or deformities. Every incident of prolonged heel pain should be checked by a sports podiatrist. Other serious conditions such as a stress fracture, bone tumor or bone cyst may masquerade as Sever’s disease.

To reduce the heel inflammation, after a sports event or at any time before you can get to the office, place an ice pack on the afflicted area for about 20 minutes. The importance of rest can not be overemphasized. In addition to calf and hamstring stretches, you should obtain a pair of 1/4″ heel lifts. Placed in both shoes, these help to alleviate the tension at the back of the painful heel. An OTC insole is often very helpful if one is unable to visit the doctor right away. Foot health problems, from whatever causes, affect the lifestyle of young athletes and their parents. Regular podiatric examination and care when there is a problem will help assure that life is fuller and more satisfying for all.  ~ Dr. Jeffrey J Niccoli   Board-Certified, Alameda Family Podiatry Group   Serving  Bay Area patients from San Francisco, Oakland, Fremont, and Alameda

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