From Ms Jo Dartnell , Consultant Paediatric Orthopaedic Surgeon
As a parent myself, its always tricky to know what aches and pains to listen to and which to ignore. Heel pain in children is one of the most common orthopaedic problems referred to us. Hopefully, this blog can help you decide whether this is one of those problems that you should ask for help with! The vast majority are completely fine.
A few questions to ask first:
- Is it definitely the heel that is sore? Younger kids find it hard to say exactly where the pain is. Any concerns, see a Dr.
- How old is the child – under 6 heel pain is less common – see a Dr.
- Has there been any trauma – yes – worth a trip A&E? No – qu 4….
- Is it sore and warm to touch – see a Dr.
- Is it both heels or just one? Both is much more reassuring and more likely to be benign. One sided –see a Dr.
- Is the pain waking them from sleeping – yes- see a Dr. Pain in the morning and after exercise is more likely to be benign and respond to stretching.
What is the most likely problem?
As children grow taller, their heel bone (calcaneum) also grows. It is then pulled on from either end, by their Achilles tendon (end of their calf muscle) and their plantar fascia (tissue on the sole of their foot). These soft tissues have to stretch too but as they do, they pull on the growing bit of the bone. This is then felt as pain by the child and known as Sever’s disease. It’s NOT a disease! That’s just a historical name and its easily treated. It may well affect the tendon either side as well which will get inflamed and stiffen up. By doing stretching exercises this helps reduce the pull on the bone and tendons and lessens pain.
We all know kids in pain are even less co-operative than normal, so if their heel hurts, give them pain-killers. For Sever’s, ibuprofen is the best as it gets the inflammation down. Give it regularly for a week or not and do the stretches below. They are much more likely to do their stretches if its not hurting. Pick your time of day to do the stretches and build it into your child’s routine. Mornings are pretty chaotic in my house, so evenings, before bedtime work well.
So what to do….
Put hands against a wall with both feet lined up behind each other. Keep heels on the floor and bend both knees. You will feel the back calf stretching. Hold for 10 seconds and change over. Repeat at least 5 times.
Stand with the ball on the foot on a step and push heel downwards. Should feel a good calf stretch. Hold for 10 seconds, relax and repeat at least 10 times. This can be done anywhere and is so easy!!
As with any medical condition, if its not improving and worsening despite treatment, see a Dr. If you’re worried, see a Dr!