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Heel Pain in Children

FACA - Heel pain in children2

Understanding Children’s Heel Pain

The most common cause of heel pain in children is calcaneal apophysitis, also known as Sever’s disease. This condition involves irritation of the heel’s growth plate (physis) and typically affects kids ages 8–14 who are still growing. Because the growth plate is softer during development, repetitive stress from sports or activity can lead to inflammation and discomfort. While temporary, the pain can significantly limit play, exercise, and mobility if untreated.

Common Youth Heel Pain Causes

Several factors increase strain on the heel growth plate:

  • Overuse in sports: High-impact activities such as basketball, soccer, gymnastics, and track put repeated strain on the heel.
  • Hard-playing surfaces: Surfaces like concrete courts and artificial turf increase stress on the growth plate.
  • Poor footwear: Lack of cushioning or support can worsen heel conditions.
  • Tight Achilles tendon: Limited flexibility can increase tension at the heel.
  • Flat feet or high arches: Abnormal foot mechanics affect how pressure is distributed.
  • Obesity: Extra weight adds additional strain on developing bones and joints.

Signs of Heel Pain in Children

Children may not always verbalize their pain clearly, so be sure to watch for:

  • Pain in the back or bottom of the heel
  • Limping after practice or long activity
  • Walking on tiptoes to avoid heel pressure
  • Stiffness or tightness in the ankle or foot
  • Pain when the heel is gently squeezed
  • Avoiding sports or physical play

How We Diagnose Pediatric Heel Pain

Diagnosis begins with a thorough physical exam and your child’s activity history. We evaluate tenderness around the heel, Achilles tightness, and gait mechanics. X-rays help assess the health of the growth plate in the heel, as well as fractures or other bone issues. Advanced imaging techniques, such as MRI or ultrasound, are rarely necessary but may be used in complex or persistent cases.

Heel Pain in Children Treatment

Most cases of calcaneal apophysitis respond very well to conservative care:

  • Activity modification: Temporary break from high-impact sports
  • Supportive shoes & orthotics: Cushioning and proper arch support
  • Anti-inflammatory medication: Ibuprofen for pain and swelling
  • Physical therapy: Stretching, ice therapy, ultrasound
  • Immobilization: A boot or cast for severe or prolonged pain
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When to See a Heel Pain Specialist

If your child has heel pain that doesn’t improve with a short period of rest, causes a limp or avoidance of activity, or returns with sports, a pediatric foot specialist should evaluate it. Early treatment helps prevent chronic discomfort and keeps kids active and confident.

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Frequently Asked Questions