The Running Doctor: Heel pain
This problem is often caused by a condition known as apophystis of the calcaneus (heel bone) or Sever’s Disease.
This condition consists of an inflammation of the growth area (heel plate) of the heel bone which has not completely matured, or closed together, and has developed in two parts. It is most commonly seen in boys and girls between the ages of ten to fifteen.
The pain is usually present in the back of the heel and is more pronounced in running and jumping sports. Sometimes there is a limp in the child’s gait, of which he may not even be aware. It has been described as an osteochondrosis, which is a loss of blood supply to the apophysis. or heel bone. These young athletes will usually complain of a dull, painful sensation in the area directly behind the heel and lower than the Achilles tendon.
In addition to the trauma and stress created by running sports, there are other contributing factors that result in the inflammation of the growth plate. These include biomechanical foot imbalances of abnormal pronation (inward rolling of the feet), or a high-arch foot, cleated or improperly fitting shoes and improper training methods.
Treatment consists of X-ray evaluation to make a proper diagnosis and to rule out any bone fractures. An orthotic insert is often needed to correct the biomechanical imbalances which may be causing a jamming effect on the heel plate. In addition, eliminate the use of any cleated shoes with less than four cleats in the heel area.
In summary, watch for any warning signals; when a child complains of heel pain, there is usually a need for examination.
Dr. Robert F. Weiss, a sports podiatrist, was a member of the Medical Advisory Committee of the 1984 and 1988 Olympic Marathon Trials. Weiss is a veteran of 35 Marathon & has a practice in Darien; affiliated with Stamford Hospital and member of Stamford Health Medical Group-Foot & Ankle. For info visit his Web site at www.stamford
healthmedicalgroup.org, and find a Physician-Dr. Robert F. Weiss.