My Athletic Child Has Foot Pain

As childhood obesity skyrockets, video game consoles seek for ways to make their games "active" and obesity related disease such as diabetes is at epidemic levels, athletics is a blessing to many children. Since children are less likely today (compared to 20 years ago) to run outside, ride bikes or play sports in the streets, more children are becoming active through sports from soccer and football to gymnastics and dance. Since activity is imperative for health, this increased activity has improved the health of many children. Foot pain, especially heel or ankle pain can interfere and even discourage continue participation in the sports.

When a child between the age of 9-14 in girls or 9-16 in boys presents to my office complaining of either heel pain or ankle pain, the cause is usually the same. The entity is commonly known as Severs Disease or Calcaneal Apophysitis. Since this is a disease of growing bone, it only presents in children during the active stages of bony growth. Let me explain some.

In a growing bone, there is a region called the physis that consists of cartilaginous tissue instead of calcified bone. As the bone grows, this allows expansion and calcification at the edges to help produce this growth. As the bone reaches full growth potential, the physis is calcified and replaced by healthy bone. This physis, however can be affected by pressure or tension and can become painful.

In calcaneal apophysitis, the growth plate of the heel bone (or calcaneus) receives tension during sports from the Achilles tendon (the strongest tendon in the body). This pressure causes increased stress, swelling and associated pain to the posterior heel area close to where the Achilles tendon attaches. The pain is caused by stretching of the physis or apophysis of the heel from a tight Achilles tendon during running. This pain can be problematic and significantly interfere with activities, and over the years has even stopped many from playing the sports they love. Although the severe pain may limit activities for years, it ultimately resolves when the bone stops growing. This is no longer the case. There are treatment options that can alleviate the pain and maintain the active lifestyle required to help our children remain healthy.

Calcaneal apophysitis or Severs Disease was once a disease of boys playing soccer. With the increased competition levels in all sports including dance and gymnastics, we are encountering this problem in boys and girls when they are active. Think calcaneal apophysitis whenever your child is in the age range of 9 - 16 and complains of heel pain, especially when running or being active in sports. Get treatment from a foot and ankle specialist and help alleviate the pain associated with the exercise our children enjoy. Don't make them stop their sport because of foot pain, help them resolve the pain while they await calcification of the growth plate and complete resolution of their symptoms.