Heel pain is not uncommon in children, and can make sports and other activities difficult to participate in. The cause of most heel pain in children differs somewhat from heel pain in adults, and is therefore treated a little differently. This article discusses the nature of heel pain in children, and how it can be relieved.
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Heel pain is common across all age groups and activity levels. In adults, this pain is usually caused by inflammation of a ligament on the bottom of the arch called the plantar fascia. Commonly referred to as a heel spur since a bone spur sometimes accompanies this condition (although the spur itself is not the source of pain), this painful injury is usually caused by abnormal foot structure straining the arch tissue. It is commonly found in those with flat feet, high arches, or those who work on ladders or stairs frequently. Treatment involves reducing the inflammation with medicine, stretching the arch, and supporting the foot structure with shoe inserts. Some children can also get this condition, particularly if they are flat footed or are obese. However, the majority of the time, heel pain in children is caused by a natural process that affects the growth plate in the heel bone (calcaneus).
As humans grow, the bones become longer and wider. Although some foot bones initially develop from cartilage molds before birth, the majority the foot bone size develops from growth plates found within each bone. These growth plates are soft areas found at one end of the bone or the other, and are set up to produce bone like a factory, constantly pushing bone out in a direction away from the growth plate. This effectively lengthens and widens the bone. Eventually, in the late teen years, this growth stops and the growth plates themselves fuse into bone. In the heel bone, the growth plate is located along the bottom back of the bone, where the heel bone is rounded to form the ‘ball’ of the heel. Sometime in late childhood to the early teen years, inflammation and swelling can begin to develop in the growth plate region. Not every child experiences this condition, also known as Sever’s disease. It can develop on its own without injury or overactivity, although chronic repetitive stress can have a role. Girls seem to develop it earlier, presumably because of earlier growth activity.