North Central Office
540 Madison Oak,
Suite 260
San Antonio, TX 78258
(Stone Oak Medical Office Bld. at North Central Baptist Hospital)

Live Oak Office
12413 Judson Rd., Suite 250
Live Oak, TX 78233
(210) 490-3668

CHILDREN'S HEEL PAIN

Children rarely develop plantar fasciitis. Children in the age group from about ages 9 to 13 may have a unique type of heel pain related to the fact that the growth plate in their heels is still open and is moving toward being closed.

The child's heel is made up of two areas of bone (ossification centers); one in the body of the heel bone and one in the area beneath the achilles tendon.

The area in between the two parts of the heel bone is called a growth plate. The area of bone in the back of the heel bone, immediately behind the growth plate is called the calcaneal apophysis. Calcaneus means heel bone.

The achillles tendon attaches to the area of bone right in back of the heel bone and that area is called the calcaneal apophysis. An apophysis is an area of growing bone adjacent to a growth plate, to which a tendon attaches. When that area becomes inflamed or painful, it is known as calcaneal apophysitis.

Eventually the heel bone becomes one bone so if the area is inflamed, the condition will go away once the apophysis no longer exists. The years while the growth plate is open and while calcaneal apophysitis is raging can be quite painful. This problem has become more common than in prior generations in part due to the popularity of soccer as soccer shoes tend to place a lot of strain on the area.

Luckily, this is a problem that has a cure that is better than 99 percent effective. The cure involves the fabrication of a specialized orthotic made from a model of the foot. The orthotic is very deep in the heel area and conforms very closely to the contours of the foot. The goal is to create a device that minimizes motion in between the two pieces of bone. Placing soft pads in the area can provide some temporary relief but often aggravate the problem since the soft surface actually can increase motion between the two bones.

Occasionally, it is necessary to modify the soccer shoe by placing a wedge in between the outsole and midsole of the shoe that does not let the heel drop backwards too much but is an easy modification to do in the foot specialist's office.