one of my specialties is pediatric foot problemsand the most common problem i see in kids is heel pain. now there's one primary causeof heel pain in children, or at least the most common cause, and that's the conditioncalled calcaneal apophysitis. it's also called sever's disease. now when we're born, thisheel bone here is made of all cartilage, and then it starts to go from cartilage to boneand it starts growing in two areas into bone, one, the main area is up here, and the otherarea is in the back of the heel. in between here, it's cartilage. at about the age of 9, 10, 11, 12, or usuallysomewhere between 8 and 13, you've got an area that's almost all bone here, bone here,with a very thin layer of cartilage in between.
that's the growth plate, also called the apophysisof the bone, and that's the weakest portion of the bone. in kids, particularly activekids, you have two big structures that attach into the bone here and here and basicallystart playing tug of war with it and it can start to irritate the growth plate. so youhave the structures are the achilles tendon attaching in there and the plantar fasciaattaching in down there. apophysitis, "-itis" just means "inflammation,"and again, apophysis of the growth plate. so all this is is an inflammation of the growthplate. now left alone it will get better all by itself, but it can take several years forthat to happen, so we will almost always want to treat it. so our two primary goals areto get tension off of this region and to get
rid of the inflammation. now to get tensionoff of it, we want to take tension first of all off the plantar fascia. and the plantarfascia gets tight when that foot flattens down. so we're usually going to get a speciallymade, these are actually pre-fabricated over-the-counter supports that are made for children, and theygo underneath the arch and they stop that arch from going down and they take tensionoff the plantar fascia. and then second is we might use a lift a little bit under theheel to take tension off of the achilles tendon. those two things together do a great job oftaking stress off the growth plate of the bone and letting that tissue heal. in some cases, we do need to put the childinto a walking boot for a couple of weeks
and really just let it rest. that type oftreatment, along with some icing and some anti-inflammatory medications in some cases,will almost always eliminate the tension and pressure and then get rid of the inflammationin that area. so this is usually is a fairly easy problem to treat. if you're in our area and your child is havingheel pain, please make an appointment to come in and see us. if you're not in our area,find a podiatrist that does specialize in pediatrics and particularly pediatric sportsmedicine. if you want more information on this, just go to our website and do a searchfor "children's heel pain." we have a lot of information there on some home treatmenthints. you might want to try those for a couple
weeks and if you're still not better, thengo see a podiatrist. if you like these videos, please subscribe to our channel and thanksfor watching.