Question
My 7 year old son keeps complaining of severe pain in the right heel.  This pain is not continuous, but occurs mostly when the heel hits a hard surface.  From July he started playing football and goes for practice thrice a week.  He wears stud shoes that fits well. He started complaining of this pain only three week back.   What do you think this pain is.  Have taken an x-ray and the report is normal.  Could  you list out the causes and treatment for this please.   Thanks  - Linda

Answer
Hi,

The heel pain is likely calcaneal apophysitis or Sever's disease. This is common during sports and results from inflammation of the heel growth plate.  X-rays are typically normal.  

Sever's Disease

The spontaneous development of pain in children generally indicates some form of injury to the growth plate of a growing bone. This can occur without a specific memorable event. When pain occurs in the heel of a child the most likely cause is due to injury of the growth plate in the heel bone. This is called Sever's disease. A condition that may mimic Sever's disease is Achilles tendonitis. Achilles tendonitis is inflammation of the tendon attached to the back of the heel. A tight Achilles tendon may contribute to Seiver's disease by pulling excessively on the growth plate of the heel bone. This condition is most common between the ages of 8 - 15 years of age and boys tend to be affected more than girls. It is frequently seen in the active soccer, football or baseball player. Sport shoes with cleats seem to aggravate the condition. It is believed that the condition is due to an underlying mechanical problem with the way the foot functions.

Treatment

Home treatment consists of calf muscle stretching exercises, heel cushions in the shoes, and/or oral anti-inflammatory medications like Tylenol or Advil. Icing the area may provide some temporary relief. If the condition persists the child should be evaluated by a podiatrist for abnormal foot function. In severe cases a below the knee walking cast may be required. Treatment may require the use of custom-made shoe inserts called orthotics. Orthotics work by correcting foot function and will fit into most normal shoes.


See the link below.
http://www.thetampapodiatrist.com/document_disorders.cfm?id=131



Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
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