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Mum!!! My Heel Hurts!!

"The back of my heel hurts!"

Parents all over hear these words at this time of year from their 9-14 year olds. Usually it is after a day of playing sport but sometimes it is just a pain that gets worse over a period of weeks or month.

“Put some ice on it and get a good night’s rest. It’ll be better in the morning. It’s just growing pains.” Often advice given by Mums and Dads trying to reassure their son or daughter that things will improve.... But often they don’t. The child will often continue playing sport and the condition continues to cause pain and discomfort. Often football boots will trigger the initial signs and usually sport generally exacerbates things. It’s not getting better. Sometimes the child doesn’t want to play sport and sometimes they are in so much discomfort that they can’t walk properly.

First thing's first..... “Growing pains” are not normal. Often they are caused by tight muscles and tendons due to growth but they shouldn’t elicit this kind of pain on their own. It is related to growth which is why we see this kind of complaint throughout puberty but is also an overuse of the area. So what is this heel pain and what can we do about it?

The pain that your child is referring to is most commonly referred to as Severs Disease. It’s medical name is calcaneal apophysitis. It occurs when the long bones of the legs grow at a greater rate than muscles that are responsible for movement in the lower limbs. These muscles attach to the bones via tendons. The calcaneus is the heel bone and the tendon that attaches to it is one of the largest in the body known as the Achilles Tendon. You can feel it behind your ankle joint and when pulled on by the calf muscles it allows you to point your foot downwards, or plantar flex the foot. It is used heavily in running and walking because it plantar flexes the foot to help propel you in a forward motion. In children, there is lots of cartilage in the area where the achilles anchors itself to the heel bone. In adults this area has developed to bone but because this bone is not a prevalent in children there is often an area of weakness and the anchor point can become stressed and inflamed causing pain.

Often this pain will resolve itself in a week or two but sometimes this doesn’t occur and things continue to worsen. What can we do as concerned parents?

  • Rest! As much as it may pain your child to withdraw from their sport, pain is the body’s natural indicator to stop and rest. Activity may be modified to continue to stay fit but your health professional can advise you on this.

  • Apply icepacks to the affected area. Take one to the game or training and ice immediately after activity ceases. Remember, Severs is an inflammatory condition. Icing will reduce the inflammation and improve the pain.

  • A biomechanical assessment can sometimes help identify ways in which we can improve the way in which the foot, its muscles and tendons interact with bones. By improving the way in which the child moves, the body can heal itself faster and improve effectiveness.

Most importantly is that pain of any description is not normal. Pain is the body's way of letting us know there is problem. Try a few of the remedies that we have discussed and if they don't seem to improve things, give us a call or book an appointment online. We are here to help!

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