Heel pain can also occur in children, most commonly between ages 8 and 15, as they become increasingly active in sports activity in and out of school. This physical activity, particularly jumping,
inflames the growth centers of the heels, also known as the apopyhsis. The more active the child, the more likely the condition will occur. Your doctor may also describe the condition as Sever's
Disease or calcaneal apophysitis.
This condition most commonly occurs due to repetitive or prolonged activities placing strain on the heel's growth plate, typically during a period of rapid growth. These activities (or sports)
usually involve excessive walking, running, jumping or hopping. Severs disease may also be more likely to occur following a poorly rehabilitated sprained ankle, in patients with poor foot
biomechanics or those who use inappropriate footwear. In young athletes, this condition is commonly seen in running and jumping sports, such as football, basketball, netball and athletics.
Symptoms of calcaneal apophysitis may include pain in the back or bottom of the heel, Limping, walking on toes, difficulty running, jumping, or participating in usual activities or sports. Pain when
the sides of the heel are squeezed.
You may have pain when your doctor squeezes your heel bone. You may have pain when asked to stand or walk on your toes or on your heels. You may have pain in your heel when your doctor stretches your
calf muscles. Your doctor may order x-rays of the injured foot to show an active growth plate.
Non Surgical Treatment
Massage the calves gently from the knee to the heel, being especially careful around the Achilles? tendon, as this will be extremely tight and tender. During this massage, flex and point the foot
through normal pain-free ranges of motion to increase flexibility while massaging. Massage every other or every third day, making sure your young athlete is not still sore before massaging again. If
you?re unsure how to massage, find someone in your area that uses Graston technique or Active Release Therapy for best results. Stretch your athlete?s calves. This is the most overlooked aspect of
treatment for Sever?s Disease and this needs to be done every day after practice, and when first starting we recommend 2-3 times per day, allowing gravity to pull heel down, never forcing the
stretch. Ice your heels, but don?t just put an ice pack there. Use a cold water soak to fully immerse the foot and calves up to the knee. We recommend using a rubbermaid can found here. Soak for
10-15 minutes. The water does not have to be frigid, just cold. Use cold water from the tap, insert the foot, then add some ice to help bring down the temperature. When your athlete is experiencing
pain, ice every hour, on the hour, for as many times as possible in one day. Make sure the heel/calves are body temperature before beginning again. Support the arches. This is what has been shown in
studies to reduce pain in young athletes with Sever?s Disease. If you miss out on this one, you miss out on relieving your athletes pain.
Perform a well rounded dynamic warm up before activity. Perform a good static stretching routine after activity. Increase core strength. Perform exercises that emphasize active lengthening of the
calf muscles. Use proper footwear. Avoid excessive running or jumping on hard surfaces like concrete by using better surfaces such as asphalt, gymnasium floors or grass.