Sean, at 12 years of age, was the star forward on his soccer team. The season started out well, but after the second game, Sean developed pain in both heels. He, his parents, his coach, and his pediatrician were all perplexed, especially since he had no history of injury.
Someone told Sean’s parents about our office, and they made an appointment. On examination, there was pain on the sides and soles of both heels. X-rays were taken and showed a growth plate disturbance called “calcaneal apophysitis” or “Sever’s disease”. Sean was treated with strappings of the feet and modified rest. On follow-up a week later, his pain was gone and he was able to return to play with some heel cups in his shoes.
Several conditions can cause heel pain in children, including stress fracture, bone infections, and tumors. All of these more serious conditions are fortunately uncommon. The most common cause of heel pain in children is Sever’s disease. This benign condition , first described by American surgeon Dr. James Sever in 1912, is a temporary disturbance in the apophysis, or secondary growth center of the heel bone. It occurs in children of ages 8-15 years, especially athletic children. Treatment consists of temporary protection and immobilization of the foot with a strapping, or more rarely, a boot, for a week or two, followed by heel cups worn in the shoe for a few months.