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Are Your Child’s Heels Sore Since Returning To Sport?

The return of winter sports such as soccer and rugby brings an influx of children to the clinic suffering with heel pain. Calcaneal apophysitis, more commonly known as Sever’s Disease is an irritation of the growth plate in the heel leading to heel pain during and after sports. This growth plate is present in all growing children and is most likely to be an issue between the ages of 8 to 14.



What Causes Sever’s Disease?


There are a number of factor which can contribute to the development of heel pain in children. These include:

Recent growth spurt: As a child’s bones grow, their muscles take time to stretch and can become quite tight. This muscle tightness increases the traction on the growth plate.


Return to sports: A significant amount of load is placed on the calf muscle and Achilles’ tendon during sport. The explosive and dynamic movements required when playing rugby and soccer can quickly lead to irritation of the calcaneal growth plate.


Flat feet: Flat feet or poor foot posture changes the way the load is placed on the Achilles’ tendon and the heel bone.

Flat shoes (or boots): Almost all football boots are flat. In comparison, most runners and school shoes have a heel pitch of between 8-12mm. This heel pitch dramatically reduces the load placed into the calf muscle and the Achilles’ tendon in normal running shoes and is part of the reason heel pain is so common in rugby and soccer.


How Can Sever’s Disease Be Treated or Prevented?


Sever’s disease can be managed and treated. Around 14 years of age, the growth plate will fuse and the heel will no longer be painful. Until that time, there are a number of ways we can work to manage this condition.


Ice and anti-inflammatories: Applying ice to the heel after exercise can help in easing some of the pain your child may be experiencing. Oral anti-inflammatories such as ibuprofen can be beneficial in easing some of the pain though always speak to a GP before taking any oral medications.

Graduated return to sport: If the heel is already sore, this can be more difficult but ensuring a good pre-season can condition the body to the rigours of sport before going straight into the season. If the heel is already sore, we may need to manage your child’s activity levels.


Massage: Using massage techniques, we can work to decrease the tension in the calf muscles to reduce the force on the heel.


Football boots with a heel pitch: Asics Gel Lethal football boots have a 10mm heel pitch built into the boot. This more closely resembles the structure of a neutral running trainer and may be sufficient to deload the calf muscle.

Custom foot orthotics: Orthotics will often be used to deload the tissues through the foot. This can include a heel raise and arch support to decrease the tension placed on the Achilles’ tendon.


Once pain levels have reduced, we would work to increase the range of the calf muscles through a stretching and strengthening regime.


Don’t let pain stop your child from enjoying sports. Book in with the team at My Family Podiatry for an assessment and a plan to manage your child’s heel pain. Call 3088 6116 or click the link below.




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