Heel Pain in Active Kids

Working with representative sports kids and their parents, I see a lot of heel pain following activity. The most common cause of heel pain in kids aged 10-12 is Sever's Disease.

Kids Playing a Lot Of Running Sports Are At Risk Of Some Common Injuries

The first sign your child might have Sever’s Disease is stiffness in the heels after a game. Once the condition progresses you may see them limping after a game, training, or even during the game. It can affect one or both feet.

Severs Disease is a traction apophysitis affecting the bony growth at the spot where the Achilles tendon joints onto the heel bone. It’s caused by repetitive trauma normal in running, but such that overloads the bodies capacity to heal the specialised tendon fibres at this spot.

It’s very common in kids doing running sports particularly between the ages of 10-12 because of growing pressures affecting the legs and because the heel bone is still yet to ossify- that is it’s not fully fused yet. (It fully fuses in kids around the ages of 15-17)

Management Strategies:

• Ice before and after games can help with the stiffness.

• Rigid taping of the ankles pre training and games can help off-load the Achilles tendon- although repeated use may irritate the skin

• Calf stretching every day can help with pain and stiffness (see images below)

• Load management is very important- get a diagnosis early and talk to your coach about managing sprinting sessions until symptoms improve. Your child can do make up fitness in the pool or on the bike until symptoms improve.

• Heel lifts and orthotics can make the mechanical load easier on the tendon insertion, although this will help some kids more than others depending on their biomechanics.

• Strengthening the feet and calf muscles is an effective long-term strategy, although strengthening work must be done very slowly and carefully to avoid irritating the site of pain (Here is a video Ive shot on how to strengthen calf muscles)

• Boot and shoe selection is important to minimise the stress on the area. Boots should be well fitted, with a softer innersole. Jogging shoes with a bigger heel pad will be better for your child than stiff soled shoes like traditional school shoes.

If your child is struggling with ongoing pain its important you seek medical advice from a trained professional. Not all foot and ankle pains are Sever’s Disease. Other conditions may require different management strategies.

Two Stretches for Kids with Sever's Disease

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