Millions of American children participate in team and individual sports, many of them outside the school system, where advice on conditioning and equipment is not always available. Parents should be concerned about children’s involvement in sports that require a substantial amount of running and turning, or involve contact. Protective taping of the ankles is often necessary to prevent sprains or fractures. Parents should consider discussing these matters with their family podiatrist if they have children participating in active sports. Sports-related foot and ankle injuries are on the rise as more children actively participate in sports.

The heel bone is the largest of the 26 bones in the human foot. In children, the heel is still growing, and the growth plate can become inflamed with overuse, especially among kids who play sports such as soccer or basketball. This condition is called calcaneal apophysitis, or Sever’s Disease.

Symptoms

• Heel pain that grows worse with activity. 
• Pain with side-to-side compression of the heel.
• Pain when standing barefoot on one foot.

When to Visit a Podiatrist

If your active child complains of persistent heel pain or is avoiding activity due to pain, and they’re not responding to rest, icing, or over-the-counter medications, it’s time to visit an APMA-member podiatrist.

Diagnosis and Treatment

The podiatric physician will examine the area. They may take X-rays to rule out any other pathology, but diagnosis of Sever’s Disease is usually based on a clinical exam.

Treatment is to reduce inflammation with oral steroids or anti-inflammatory medications. Your podiatrist may suggest calf stretches or prescribe a soft heel cup or orthotics to help reduce shock to the growth plate. The goal is to ensure kids can get back to their activities without pain.

Sometimes reduction of activity is required, or immobilization in a walking boot, but usually Sever’s Disease clears up with conservative treatment. 

During back-to-school season and throughout the year, one of the most important purchases on any parent’s shopping list should be a pair of proper fitting shoes for their child. For many parents, shoe shopping may seem easier than a pop-quiz in gym class, but several important factors should be considered:

• Children’s Feet Change With Age. Shoe and sock sizes may change every few months as a child’s feet grow.
• Shoes That Don’t Fit Properly Can Aggravate the Feet. Always measure a child’s feet before buying shoes, and watch for signs of irritation.
• Never Hand Down Footwear. Just because a shoe size fits one child comfortably doesn’t mean it will fit another the same way. Also, sharing shoes can spread fungi like athlete’s foot and nail fungus.
• Examine the Soles. Children may wear through the sole of shoes more quickly than they outgrow shoes. Uneven wear in the toe or heel can indicate a foot problem that should be checked by a podiatrist.  
• Take Your Child Shoe Shopping. Every shoe fits differently. Letting a kid have a say in the shoe buying process promotes healthy foot habits down the road.
• Always Buy for the Larger Foot. Feet are seldom precisely the same size.
• Buy Shoes That Do Not Need a “Break-In” Period. Shoes should be comfortable immediately. Also make sure to have your kid try on shoes with socks or tights, if that’s how they’ll be worn.