Pain in the rearfoot of children is not common, however when it does happen, the most frequent cause is a problem referred to as Severs disease. It is not a real “disease”, but it is the name that has unfortunately stuck. It is actually properly named calcaneal apophysitis. It is a problem with the growing region at the back of the heel bone. As it is a disorder, of the growing bone, the disorder is self-limiting and will no longer be an issue once the growth of that bone has concluded. It is more prevalent around the age groups of 10-12 years.
The classic symptom of Severs disease are usually pain on exercise and pain on squeezing the sides of the rear area of the heel bone. To begin with the soreness is relatively minor and does not impact activity much, however later it will become more severe and affects athletic participation and may also cause limping. The exact reason for it is not clear, but it is certainly an overuse type issue as it is more prevalent in those who play more sport and more frequent in children who have got a higher body weight. Children with tighter calf muscles may also be at a greater possibility for the development of this condition.
Commonly, the treatment of Severs disease is load management. The child is encouraged to remain active, but simply cut back exercise amounts to a level which can be coped with and not too uncomfortable. A soft heel pad in the shoe might be helpful to cushion it. Ice soon after exercise may also be helpful to help the inflammation. If the calf muscles are tight, then a stretches needs to be started. Sometimes foot orthotics can be helpful when the arch of the foot is overpronated. On rare occasions a brace may be used, and all activities stopped until it heals. By the mid-teens the growth plate that this occurs at merges with the rest of the heel bone, which means this ceases to be a problem at those ages.