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.

CHECK KIDS’ FEET BEFORE SCHOOL STARTS

Simple At-home Checks Help Spot Foot Problems

During the annual rite of preparing for the new school year, it is recommended that parents take five minutes at home to check for signs of possible foot disorders that could prevent active children from participating in sports and other activities.
The American College of Foot & Ankle Surgeons (ACFAS) suggests these additions to this year’s back-to-school checklist:
• Do the bottom of the child’s shoes show uneven wear patterns?
• Does the child walk irregularly? Is one leg longer than the other or do feet turn in or out excessively?
• Do pre-schoolers walk on their toes?
• Does the child often trip or stumble?
• Does the child complain of tired legs, night pains and cramping?

If parents take time to perform these checks, they will identify symptoms of common foot ailments, such as ingrown nails, and more serious foot disorders like flat feet that can hamper a child’s performance in physical education classes and sports. If a child’s shoe is worn on the big toe side of the foot, it could be a sign of poor arch support or flat feet.

Parents can spot several potential foot problems by observing kids’ walking patterns. For example, if a parent determines that one leg is longer than the other, heel lifts may be required to restore proper balance.

Toe-walking in younger children can result from too much time spent in walkers as toddlers. Parents are urged take action to correct tightness in the Achilles tendon area that occurs from excessive toe-walking. ACFAS recommends stretching exercises that can be fun for small children and will help prevent lower back pain as they get older.

For those beginning college, heel pain and shin splints can plague freshmen not acclimated to walking long distances across campus to attend classes. Daily stretching and proper walking shoes are recommended, and for those with deformities such as hammertoes, surgery may be necessary to make walking more comfortable.
Parents also should heed complaints about tired legs, heel pain and leg or foot cramps at night. There’s no such thing as “growing pains,” so when kids complain about leg and foot pain they might have flat feet or another disorder that should be evaluated immediately. Children with flat feet are at risk for arthritis later in life if the problem is left untreated.

Parents who notice a potential foot problem should have the child evaluated by the foot specialist at Central Kansas Podiatry Associates.