Indoors and outdoors, youth athletes stay active year-round in competitive sports. And for many of them, heel pain has become "just another part of the game." The American College of Foot and Ankle Surgeons advises that, when a child complains of heel pain, it should be diagnosed promptly, because it may be a warning sign of a serious foot problem.
Dr. Karl Collins, DPM, FACFAS, a St. Louis-area foot and ankle surgeon, says heel pain occurs frequently in children ages 6 to 14 as their feet grow and the heel bone develops. "As children become more active in sports, they increase their risk for growth plate injuries and subsequent heel pain," says Collins. This is especially true during the school year, when surgeons see an increase in middle- and high-school athletes experiencing heel pain from sports.
"New bone forms in an area behind the heel, known as the growth plate, and cartilage is vulnerable to severe inflammation from strain or stress. With repeated stresses and strains from overactivity, the heel becomes very painful," Collins explains.
Even though growth plate trauma is the leading cause of heel pain in young people, Collins says the condition can be difficult to diagnose. He cautions that parents should be concerned if a child has pain in the back or bottom of the heel, limps, walks on the toes, or seems to have difficulty participating in normal recreational activities. To diagnose the condition, foot and ankle surgeons examine the child's foot and leg, and often take imaging tests to rule out other serious causes of heel pain, such as bursitis, tendonitis and fractures.
In most cases, mild or moderate heel pain can be treated successfully with shoe inserts to soften the impact on the heel, anti-inflammatory medications, stretching and physical therapy. In severe cases, the foot and ankle will be immobilized in a cast. In some instances, surgery may be necessary.
Heel pain in young people often returns after treatment, because the growth plate is still forming until the age of 14 or 15. However, the risk for recurrence can be lowered by choosing well-constructed shoes with good support and restricting use of spiked athletic shoes, especially on hard fields. It also is advised that young athletes avoid competition that exceeds their physical abilities.