The most common cause of heel pain in adults is a condition known as plantar fasciitis. The most common cause in children is a condition known as Severs disease. This is a condition that many consider to be similar to a stress fracture, but rather than occur in bone, it occurs in the growing cartilage area in the bone at the back of the heel bone. As this is a problem with the growing area of bone, it is no longer a problem after the child stops growing. For the heel bone this is a round the mid-teenage years. The cause of Severs disease is not totally clear, but is more common in child that are heavier, are taller and are more active in sport. All of these put more strain on the growing area of the heel bone. The most common symptom of this condition is discomfort or pain at the back and sides of the heel bone that is worse after activity. For some children the pain can be bad enough to make them cry.
The first approach to treating Severs disease is to deal with the pain. This is usually done with the use of ice after sport. In the more severe cases, medicines may be needed. Next, the activity levels of the child need to be assessed and modified or reduced so that they put less load on the heel bone during the day. This can be difficult as all children have a natural tendency to want to run around with their friends, especially when parents are not around to monitor them. Some negotiation may be needed to restrict activities. A cushioned heel pad is also very useful to protect the damaged area from too great an impact. In most cases, it is just a matter of managing this and expectations and educate them as to the natural history of the condition. This will probably take care of most cases. If not, it s sometimes necessary to put them in a walking brace to really restrict their activity levels.