We often hear about the importance of our kids being active.
Whilst we wholeheartedly agree with getting children involved in sports or activities, to help set them up for a healthy lifetime, we also quite commonly see children presenting with a variety of aches and pains, that seem to come about as a result of their endeavours.
Today’s post discusses heel pain in ‘tween’ children (approx. 8-12 years old).
When is it ‘normal’?
When should they take a break from their activity?
When should you seek help?
Just like adults, many children will complain of various aches and pains, that seem to be more common when they’re physically active.
However, just like in adults, these complaints should not last more than a day or two, and should not be so severe that they start to impact on the child’s ability to join in their sport.
If these pains do persist, sometimes taking just a one week break from the sport that seems to be causing the symptoms, is enough for the body to have time to start to heal. During this time, the child should avoid any high-impact activities, such as jumping or running.
You could even try icing the area for 5-10 minutes at a time, 2-3 times a day over 3-4 days, to see if this helps break the inflammation cycle. Please be aware that you should wrap the ice pack in a cloth to avoid ‘ice burns’.
If you have tried these measures, and yet your child’s heel pain persists, it may be time to seek some help.
By far the most common cause of heel pain that we see in tweens, is a condition called “Sever disease”, a.k.a. calcaneal apophysitis.
Whilst the name may sound a little scary, it’s actually quite a benign condition, that usually responds well, without any long-term consequences, provided the right management is given and adhered to.
In a nutshell, Sever’s comes about due to the repetitive pull of the calf muscles on their attachment point on to the heel.
Pre-pubescent kids are usually growing pretty fast, and so their body struggles to meet the demands of both growth and healing from this pulling. As a result, the child experiences heel pain at the back of their foot, that worsens with activity. In 60% of cases, the child has pain in both heels.
The child will be very tender to touch around the lowest part of their Achilles tendon, where it inserts onto the bone, and will often have heel pain when they raise themselves up onto their toes.
The pain may be relieved if they sit or lay down and allow their feet to rest in a position that has their toes slightly pointed or they may even prefer to walk on their tip toes.
Osteopathic treatment is usually aimed at restoring adequate motion to all of the joints of the foot, to allow for as much shock absorption as possible. We will also examine other areas of your child’s body, such as their calf muscle tone, and ankle, knee, hip and pelvic mechanics, to see if these are playing a role.
Depending on the severity of your child’s symptoms, we will try to keep them active in their sport as much as possible. However, if your child’s pain is especially severe or chronic, or does not seem to be responding to treatment, we may suggest that they take a break from sport.
It has been shown that 85% of children are able to return to sport within 2 months (1).
Usually, the child will benefit from regular calf muscle stretching, and we can show you the correct way to do this.
There are a few other conditions that can present similarly to Sever’s, some of which can be more serious. So, if you’re not sure if what your child is suffering is actually Sever’s, then it may be time to get a professional opinion.
If Sever’s disease is suspected, or if the actual diagnosis is uncertain, we may refer your child for an X ray of their foot/feet. This does not necessarily confirm that they have Sever’s, but it can help to rule out some of these other causes.
If this sounds like your child, why not give us a call or book online today, to see if we can help?
- Micheli LJ, Ireland ML. Prevention and management of calcaneal apophysitis in children: an overuse syndrome. J Pediatr Orthop. 1987 Jan-Feb. 7(1):34-8. [Medline].