Question
Doctor I have a very active 8 year old son.  He has played soccer since he was 4 yrs. old.  He also plays flag football and basketball.  About a year ago my son started complaining about his heel hurting and burning not only after playing but also when he sits for a while and gets up to walk.  I thought that it might be from his soccer shoes because he is sort of flat footed and soccer shoes are very narrow.  What should I do?  Thank you.

Answer
Hi Gay,

Your son likely has a condition known as Calcaneal Apophysitis.  Please see the article below and you will see that this is common in young soccer players.  Typical treatments include heel cups/lifts, stretching, anti-inflammatories and custom arch supports.  In severe cases, discontinuation of activity and casting may be required.

Please see a Podiatrist first to make sure that Calcaneal Apophysitis is truly the diagnois.  Other conditions such as fracture could be present.  You need to be sure before treatment.

"Calcaneal Apophysitis: An Emerging Trend Among Kids In Soccer?
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Calcaneal apophysitis, a growth plate disorder, is characterized by a pain directly behind the heel in children. It has two probable causes. When bones grow faster than the soft tissues, there is an abnormal pull of the soft tissues away from the bone, which leads to a traction type of injury. Tight calves may have a similar effect although children usually have adequate flexibility.

Young soccer players typically play on grassy fields and I have noticed an increase in the incidence of calcaneal apophysitis during rainy stretches. After it rains, the field is softer and the foot is more vulnerable to excessive motions, whether they are toward pronation or supination. This excessive teeter-tottering of the heel and/or foot may cause irritation of the Achilles tendon against the heel bone near its insertion or of the plantar fasciitis near its origin. When treating this condition, you should focus on reducing the excessive motions of the heel and elevating the heel to reduce tension of the Achilles and plantar fascia at its attachments to the growth plate area.

Posterior heel straps and/or taping are extremely effective for limiting excessive heal motion. Adding heel lifts further reduces Achilles tension. Once you have reduced the initial pain, you should consider fabricating orthotic devices with a deep heel cup to help prevent recurrence."

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

www.fix-my-foot.com