Childhood heel pain related to growing, muscle flexibility

Rest will resolve Sever’s syndrome; stretching will keep it under control. Childhood heel pain can have many causes, but the most common is something called Sever’s syndrome. This is not a growing pain, but it is related to growing and the loss of muscle flexibility in relation to the growth of the bones.

The act of growing is primarily through our bones. So, as we grow, our bones get longer and in the process our muscles have to be stretched out to accommodate that new growth. Certain areas of a child’s body are at risk for injury because of this interplay.

One area is the heel bone. On the back side of the heel bone is a growth plate (a cartilage area where the bone grows) and attached to that growth plate is the Achilles tendon. The calf muscles that attach to the Achilles tendon will frequently lose their flexibility and then during play or increased activity there is excessive pull by the Achilles tendon on the growth plate. This results in Sever’s syndrome, a painful pulling apart of the heel growth plate.

It occurs in both boys and girls, but tends to affect girls at a younger age (8-10 years old) compared with boys (10-12 years old). While the pain starts in these younger ages, many parents will tell you that it can often linger over the growth-spurt years in particular. About 50 percent of the time, it can happen on both heels, and it often hurts worse after play than during play.

Kids who seem to be at particular risk are those who wear cleated shoes for their sports. The cleats tend to increase the forced stretch of the Achilles during play, thus increasing the force of pull at the growth plate.

The fastest method of resolving this syndrome is rest from activities. Many of our families find it difficult to take time off from sports. However, the best rule to follow as a parent is to remember that if your child is limping during play, then the child should not be playing.

Stretching is the key to long-term success of this problem. A daily routine of stretching can help alleviate this pain and prevent it from returning. It can take up to six weeks for some athletes to stretch themselves adequately.

In the meantime, a few other therapies can be used. Icing and anti-inflammatory medications can be helpful. An over-the-counter heel lift will take some pressure off the heel growth plate. Finally, a cast can be used for a short period to give the growth plate a rest. Surgery is never necessary.

You should contact, or see, your doctor if the pain is not improving after two weeks of rest, or if the pain is associated with a fever.