Common Causes of Heel Pain in Kids

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A little boy holding his heel because he suffering from heel pain

Introduction

Heel pain is not only a common problem in adults. Heel pain is also a common complaint among kids. Heel pain in kids is not typically serious but proper diagnosis and treatment are still recommended.

Heel and foot injuries in kids are a result of overuse just like in adults. Kids who are involved in competitive sports with rigorous training schedules are at risk for having heel and foot injuries. Overuse injuries are very common but can easily be treated with rest.

Here are some of the causes of heel pain in kids:

  • Calcaneal Apophysitis (Sever’s Disease)

Calcaneal apophysitis is the most common reason for heel pain in kids aged 5 to 14 especially for those who are very active in sports. It is an inflammation of the growth plate of the heel. Calcaneus is the heel bone while apophysis is the area in the heel bone where growth occurs. The apophysis is located at the back of the heel bone near the area where the Achilles tendon is attached to. The heel bone of a child is continuously developing until he/she reaches the age of 14. New bone is developing at the apophysis or growth plate until the child reaches the age of 14. For this reason, the growth plate is still subject to tension from the tendon and pulling which results in the inflammation and pain in the heel. Inflammation can occur when there is a lot of repetitive strain or pressure on the growth plate.

Calcaneal apophysitis is an injury caused by overuse and repetitive microtrauma during running or sports activities. It can be a result of jumping, running, and sports such as soccer, basketball, and track. Obesity and biomechanics problems such as having a high-arched foot or flatfoot may also contribute to having an inflamed tissue and a muscle strain.

The symptoms of calcaneal apophysitis include:

  • pain in the bottom or back of the heel
  • pain or tenderness when squeezing the back of the foot
  • Swelling and warmth on the painful area
  • Walking on toes
  • Limping
  • Tiredness
  • Difficulty jumping, running or doing sports
  • Growing Pains Affecting the Heel

Growing pains is a normal phenomenon during growth spurts in childhood and adolescence. These pains are usually short-lived and mild. There is a possibility for a bone to grow faster than a muscle during growth spurts and this causes tendon or muscle strain that brings about discomfort or mild pain. It may occur after a day filled with activities either late in the day or at night.

  • Achilles Tendonitis

Achilles tendonitis is a result of strain on the Achilles tendon through the tightness of the calf muscles that occur during growth spurts and sudden increase in an activity like jumping and running. Stiffness and pain are often felt in the morning. Children who are involved in repetitive activities such as jumping, running, and pivoting just like dancers and basketball players are prone to having Achilles tendonitis.

The other symptoms of Achilles tendonitis include:

  • Pain in the back of the foot or heel
  • Swelling
  • Difficulty walking
  • Warmth
  • Mild pain that gradually gets worse
  • Bursitis

Bursitis is the inflammation of the bursa, a fluid-filled sac located near the part where the Achilles tendon attaches to the heel bone. Bursitis is caused by the irritation of the tendon from rubbing against tight shoes or a strain in the tendon.

Bursitis can cause swelling and pain in the heel bone.

  • Plantar Fasciitis

Plantar fasciitis is a condition where an inflammation or irritation occurs in the band of connective tissue located on the underside of the heel bone that travels along the arch of the heel to the front of the foot or also known as plantar fascia.

This condition can affect anyone of any age. Plantar fasciitis is usually aggravated by problems with foot structure like high-arched feet or flat feet but can also be a result of sudden increased activity and sports that involve a lot of jumping, standing, or running. Kids would often complain that the pain is felt in the morning and while doing certain activities.

Symptoms of plantar fasciitis include:

  • Pain in the bottom of the foot close to the heel
  • Tightness or tenderness along the arch of the foot
  • Difficulty walking
  • Pain starts off mild but gets worse over time
  • Fractures

Children who play hard and are highly involved or engaged in high-impact sports are prone to having heel or foot fracture. Heel fractures occur after a sudden impact or a fall.

Symptoms of a fracture include:

  • Severe pain
  • Bruising
  • Swelling
  • Inability to put weight on the foot that is affected

Less Common but more Serious Causes of Heel Pain in Kids:

  • Bone cysts or tumors
  • Tarsal coalitions or congenital bone fusions
  • Crohn’s disease and ulcerative colitis
  • Inflammatory conditions like juvenile spondyloarthropathies and juvenile rheumatoid arthritis can cause pain in the heel. Juvenile spondyloarthropathies include ankylosing spondylitis, psoriatic arthritis, and reactive arthritis.