HEEL PAIN IN CHILDREN (SEVER’S)
By: Robert H. Sheinberg, D.P.M., D.A.B.F.A.S., F.A.C.F.A.S.
Painful inflammation to the growth plate (calcaneal apophysis) in the back of the heel.
- Overactivity in children between the ages of 8 and 14.
- Tight muscles in the lower extremity, especially the calf muscles.
- Growth spurts.
- Poor shoe gear or walking barefoot on hard surfaces.
- Commonly seen at the beginning of a sports season inactive children.
- Trauma to the heel bone.
- Mild discomfort in the heel bone at the end of an activity.
- Stiffness in the foot in the morning and pain with walking.
- Pain alleviated by rest and a decrease in activity.
- Stiffness and pain is usually present after a child is done with the activity, sits for a period of time and then tries to get up and walk.
- Tenderness to the back and bottom of the heel with touch or grasping the heel.
- Walking on the ball of the foot to avoid touching the heel to the ground.
- Discoloration and swelling are almost never seen in the heel.
- Limping at the end of an activity that may persist as the condition worsens.
- Modification of activity.
- Heel lifts.
- Taping the foot to decrease the pulling of the plantar fascia on the heel bone.
- Proper shoe gear to support the foot.
- Avoiding going barefooted.
- Night splinting to stretch the tight calf muscle and arch ligament.
- Custom molded orthotics to support the foot and help restore proper alignment.
- Physical therapy to improve flexibility and diminish inflammation of the growth plate in the back of the heel.
- Occasional immobilization in a cast or brace to completely rest the heel and allow complete healing.