Heel pain in children is most commonly caused by Sever’s disease, a growth-related condition affecting the heel’s growth plate. It typically occurs during growth spurts in active kids aged 8-14 years and resolves with proper treatment and rest.
What Is Heel Pain in Children?
Heel pain in children is different from heel pain in adults. While adults often experience conditions like plantar fasciitis, children’s growing bodies face unique challenges. The most common culprit is Sever’s disease (calcaneal apophysitis), which affects the growth plate at the back of the heel bone.
During childhood and adolescence, bones grow faster than the muscles and tendons. This creates tension on the growth plate where the Achilles tendon attaches to the heel bone. When combined with physical activity, this tension can cause inflammation and pain. The condition is particularly common in active children who participate in sports involving running and jumping.
The good news is that heel pain in children is almost always temporary and responds well to conservative treatment. Unlike some adult heel conditions that can become chronic, children’s heel pain typically resolves completely once the growth plate fully develops and closes.
Common Causes of Heel Pain in Children
Understanding what triggers heel pain in young people helps parents and carers identify the problem early. Several factors contribute to heel discomfort in children:
Sever’s Disease
This accounts for the majority of heel pain cases in children. It occurs when the growth plate in the heel becomes inflamed due to repetitive stress. Children experiencing growth spurts are particularly vulnerable, as their bones temporarily outpace soft tissue growth.
Increased Physical Activity
Starting a new sport, increasing training intensity, or participating in activities with lots of running and jumping can trigger heel pain. Sports like basketball, soccer, netball, and athletics place significant stress on developing heels.
Inappropriate Footwear
Shoes that lack proper cushioning, support, or structure can contribute to heel pain. This includes worn-out runners, flat shoes without arch support, and footwear that doesn’t fit properly. Australian kids who spend summer in thongs or go barefoot frequently may experience increased heel discomfort.
Biomechanical Factors
Some children have foot structures or walking patterns that place extra stress on the heel. Flat feet, high arches, or tight calf muscles can all increase the likelihood of developing heel pain.
Hard Surfaces
Playing sports on concrete or other hard surfaces increases impact forces on the heel. Many Australian school playgrounds and sports courts have hard surfaces that can aggravate heel conditions in susceptible children.
Recognising the Symptoms
Children don’t always communicate discomfort clearly, so parents need to watch for telltale signs of heel pain:
- Limping or walking on toes to avoid putting pressure on the heel
- Complaining of pain in one or both heels, especially during or after physical activity
- Pain that improves with rest but returns when activity resumes
- Tenderness when the heel is squeezed from both sides
- Reluctance to participate in sports or activities they usually enjoy
- Stiffness in the heel first thing in the morning
- Swelling or warmth around the heel area
The pain typically develops gradually rather than from a single injury. It’s often worse during and immediately after activity, particularly sports that involve running or jumping. According to Health Direct Australia, the condition usually affects children between 8 and 14 years old, coinciding with periods of rapid growth.
Treatment Options for Children’s Heel Pain
The positive aspect of heel pain in children is that it responds well to conservative treatment. Most cases don’t require invasive interventions and improve with appropriate management.
Rest and Activity Modification
Reducing or temporarily stopping activities that cause pain gives the heel time to settle. This doesn’t mean complete inactivity, but rather avoiding high-impact sports and replacing them with lower-impact alternatives like swimming or cycling.
Ice Therapy
Applying ice to the heel for 10-15 minutes after activity helps reduce inflammation and pain. Wrap ice in a towel rather than applying it directly to the skin.
Proper Footwear
Supportive shoes with good cushioning in the heel are essential. Avoid letting children wear flat shoes, thongs, or worn-out runners during active periods. Shoes should have a firm heel counter and adequate arch support.
Heel Raises and Cushioning
Simple heel raises or cushioned heel cups can reduce tension on the Achilles tendon and provide comfort. These are available from most Australian chemists or through podiatry clinics.
Stretching Exercises
Gentle calf stretches performed regularly help reduce tension on the heel. A podiatrist can demonstrate age-appropriate stretches that children can do at home.
Orthotic Therapy
Custom or prefabricated orthotics may be recommended to address biomechanical issues contributing to heel pain. These devices support the foot’s structure and can significantly reduce stress on the heel.
Physical Therapy
In some cases, working with a physiotherapist alongside podiatric care provides additional benefit through targeted exercises and manual therapy techniques.
When to See a Podiatrist
While some mild heel discomfort might resolve with rest and home care, professional assessment is important for persistent or severe pain. Parents should consider booking an appointment with a podiatrist if:
- Heel pain persists for more than two weeks despite rest
- Pain is severe enough to cause limping or significantly limit activity
- There’s visible swelling, redness, or warmth in the heel
- Your child has a fever along with heel pain
- Pain occurs without any physical activity or sport participation
- Home treatments haven’t provided relief
Australian podiatrists are specifically trained to assess and treat children’s foot conditions. At Happy Feet Podiatry, we understand that children’s feet require different approaches than adult feet. A thorough assessment includes examining foot structure, biomechanics, footwear, and activity levels to create a tailored treatment plan.
Professional heel pain in children treatment at Happy Feet Podiatry ensures accurate diagnosis and appropriate management, helping your child return to their favourite activities safely and comfortably.
Prevention Strategies
While not all cases of heel pain can be prevented, several strategies reduce the risk:
Gradual Training Increases
When children start new sports or increase training intensity, do so gradually. Sudden increases in activity are a common trigger for heel pain. The 10% rule (increasing activity by no more than 10% per week) is a sensible guideline.
Quality Footwear
Invest in properly fitted, supportive shoes for sport and everyday wear. Replace worn-out runners before they lose their cushioning and support. Children’s feet grow quickly, so check shoe fit regularly.
Regular Stretching
Encourage children to stretch their calves and feet regularly, particularly before and after sports. Making this part of their routine helps maintain flexibility and reduces tension on the heel.
Cross-Training
Varying activities prevents overuse of specific muscles and structures. If your child plays high-impact sports, balance these with lower-impact activities like swimming.
Appropriate Surfaces
Where possible, encourage play and sport on softer surfaces like grass rather than concrete. This reduces impact forces on growing heels.
Listen to Pain
Teach children that pain is their body’s warning signal. Encouraging them to speak up when something hurts, rather than pushing through discomfort, prevents minor issues from becoming significant problems.
The Role of Growth in Recovery
Parents often worry about how long heel pain will last. The reassuring truth is that children’s heel pain is self-limiting. Once the growth plate in the heel closes (usually around age 15), Sever’s disease can no longer occur. Until then, managing symptoms and maintaining activity levels within comfortable limits is the goal.
Most children experience significant improvement within a few weeks of starting appropriate treatment. Some may have intermittent symptoms during periods of rapid growth or increased activity, but with proper management, they can continue participating in sports and activities they love.
Frequently Asked Questions
Should my child stop playing sport if they have heel pain?
Complete cessation isn’t always necessary. The approach depends on pain severity. If your child can participate without limping and pain settles quickly after activity, they may continue with modifications. However, if pain is severe, causes limping, or persists after activity, taking a break from high-impact sports while pursuing treatment is advisable. A podiatrist can provide specific guidance based on your child’s individual situation. Low-impact activities like swimming can often continue while the heel recovers.
Can heel pain in children cause long-term damage?
No, heel pain from Sever’s disease doesn’t cause permanent damage or long-term problems. The growth plate will eventually close and harden, completely resolving the condition. With appropriate management, children can remain active without risking future complications. This differs from ignoring the pain and continuing high-impact activities, which can prolong symptoms and keep your child uncomfortable for longer than necessary.
Are orthotics necessary for treating heel pain in children?
Not all children with heel pain require orthotics. Many cases respond well to rest, appropriate footwear, stretching, and activity modification. However, if biomechanical factors like flat feet or high arches contribute to the problem, orthotics can be highly effective. An Australian podiatrist will assess your child’s specific needs and recommend orthotics only if they’ll provide meaningful benefit. When prescribed, they’re typically part of a comprehensive treatment approach rather than the sole intervention.
Get Your Child Back to Being Active
Heel pain shouldn’t keep your child on the sidelines. With proper assessment and treatment, most children return to their normal activities within weeks. Happy Feet Podiatry specialises in treating active Australian kids, providing evidence-based care that gets results.
Our experienced podiatrists understand the unique needs of growing feet and work with families to create practical, effective treatment plans. We’re committed to helping your child stay active, comfortable, and confident in their movement.
Book an appointment with Happy Feet Podiatry today to have your child’s heel pain properly assessed and treated. Early intervention means faster recovery and less time away from the activities they love.
⚕️ Medical Disclaimer
This article is for general information purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. The information provided should not be used to self-diagnose or self-treat any health condition. Always consult a registered podiatrist or qualified healthcare professional before starting any treatment.
If you’re experiencing foot or lower limb pain, the team at Happy Feet Podiatry is here to help. Book an appointment today for a personalised assessment and treatment plan.