Heel Pain

QUESTION:  My 11-year-old son complains of pain in his heels. He often limps after soccer games. What should we do?

ANSWER:  The most common cause of heel pain in growing children is an overuse reaction in the heel bone growth plate called "calcaneal apophysitis." This occurs when the heel bone is subjected to both rapid growth and vigorous physical activity. In Roanoke, we see it most often in summer when children play soccer in unsupportive, uncushioned cleats on dry, hard fields. Children complain of achy pain and stiffness upon arising in the morning and have pain late in the day after activities. They often limp. They do not show warmth, swelling, or redness of the foot, and they do not have fevers.

Treatment may require a restriction of activities for several weeks. Over-the-counter anti-inflammation medicines, like ibuprofen, may help the pain. Ice packs often help more than heat treatments. Cushioned heel pads and arch supports can decrease the impact on the heel bone. Achilles tendon stretching also helps decrease the stress that activity places on the heel bone.

Only rarely is any more aggressive treatment necessary; however, if problems persist or increase, see your doctor.

WRITTEN BY: William M. Mirenda, Jr., M. D.