Category Archives: Heel Pain

Picture of lady thinking for post Sever's Disease in Children

Got Heel Pain… What About Plantar Fasciitis?

What is our most important mode of transportation? If you said our feet, then you were absolutely correct!

Our feet and their well-being, is critical to our livelihood and it is my job, as a practicing podiatrist, to keep them in tip-top shape.

Would you believe that heel pain (specifically heel pain related to a condition called Plantar Fasciitis) is one of the #1 complaints that I see in my adult patients?

So… what about Plantar Fasciitis makes it so common and painful?

I am here to tell you, ad nauseam, EVERYTHING that you could possibly want to know about this condition in simple, easy-to-understand terminology!

Quick note… If we are talking about a child suffering with heel pain, this is NOT where you want to be! I would recommend reading articles titled “Heel Pain in Kids – Everything You NEED to Know” or “Sever’s Disease in Children – Is It Affecting Your Child’s Game” for more information on heel pain in kids.

Back to what you came for… Plantar Fasciitis!

The Anatomy Behind Plantar Fasciitis

To effectively understand what the term “Plantar Fasciitis” means, we first have to understand what the plantar fascia band is and where it is located.

The plantar fascia band is a band of thick, connective tissue that spans along the bottom of the foot from the area of the heel bone to the ball of the foot.

When you stretch your toes up towards your nose, you can also see your plantar fasciial band through the skin. Go ahead… give it a try! You should see something like this:

This strong plantar fascia band (that you should be looking at now) plays a critical role in our feet. It functions to support the arch on the bottom of the foot and prevent its collapse due to the weight of our bodies.

Did you know that the average adult tends to take anywhere from 5,000 – 10,000 steps per day and that this band is strong enough to support our weight, yet elastic enough to withstand the impact of the force of each step?

Pretty amazing, right?

Think of the plantar fascia band as a bowstring that absorbs shock. See the importance?

Now you will be able to better understand exactly what plantar fasciitis is.

What is Plantar Fasciitis?

Simply put, Plantar Fasciitis is a condition that results when the plantar fascia becomes inflamed. Let’s talk about this in a little more detail to make sure you have a better understanding.

When the plantar fascia band is tensed, or overstretched, (for reasons that we will discuss later) tiny little tears occur within it. These “microtears” most commonly occur at the weakest area of the plantar fascia band, which is close to where it attaches to the heel bone.

Once microtears are present, this band begins to get irritated and inflammation results. This, in turn, causes it to become even more tense and it reacts by wanting to contract, or ball-up, in a sense.

For quick clarification purposes, I would like to stress right now that Plantar Fasciitis is NOT caused by a heel spur. This is so very often misconstrued. A heel spur may develop in conjunction with this condition as our bodies naturally create calcium deposits to the area in an attempt to support the damaged plantar fascia band, but these two conditions do not always go hand-in-hand.

What Causes Plantar Fasciitis – Are You At Risk?

Now that you should have a pretty good understanding about exactly what Plantar Fasciitis is, who gets plantar fasciitis?

The easy answer to this question is that ANYONE can develop it; but, generally speaking, Plantar Fasciitis most often occurs in an active man or woman between the ages of 30-60 with the highest occurrence in women.

In addition, there are certain activities/actions that can put you at a greater risk.


You are at a greater risk for Plantar Fasciitis when you are obese, or overweight… especially if there was a sudden weight gain. Why?

When a person rapidly gains weight, our plantar fascia band is subject to an increased work-load without having time to adapt to it.

This is commonly supported by pregnant females who suddenly develop this condition near the end of their pregnancy.

Extreme Physical Activity

Extreme Physical Activity can take many shapes and forms, but does put you at an increased risk to develop Plantar Fasciitis.

Does your job require you being on your feet for hours on end (such as a factory or restaurant worker)? Are you a long-distance runner?

Moderate physical activity is definitely recommended several times per week for our overall health, but putting our bodies in extreme stress regularly can often do more harm than good.

Structural Foot Deformities

Do you have a high-arched foot, or are you flat-footed? Is your Achilles Tendon tight? Add yourself to the increased risk category!

Improper, or Ill-Fitting Shoegear

Ladies… are you guilty of sporting those red bottoms or other high-heeled shoes on a regular basis?

Any shoe with soft soles or inadequate arch support is definitely a risk factor for the development of Plantar Fasciitis. And believe me… once you develop it, NOTHING is worth the pain!

Your selection of shoegear should be based upon the shoe’s ability to provide good support and fit well, not merely as a fashion statement.

What About Plantar Fasciitis Symptoms?

We can’t effectively discuss Plantar Fasciitis without reviewing the symptoms most commonly experienced by those suffering from this condition, now can we?

Some of the most common signs/symptoms associated with Plantar Fasciitis include the following:

  • Stabbing-type pain on the bottom of the foot close to the heel bone.
  • Pain on the bottom of the heel area upon rising after sitting or laying for an extended period of time that improves some with walking. The most intense pain is usually experienced on the first step out of bed in the morning.
  • Pain on the bottom of the heel that occurs immediately following exercise rather than during exercise.

How is Plantar Fasciitis Diagnosed?

Typically, I (as well as other physicians) can diagnose Plantar Fasciitis via a medical history and thorough physical examination of the foot.

For the medical history, I always ask questions similar to the following:

  • What is the nature of the pain? (Heel Pain)
  • Where specifically on the foot is the pain located? (I have them point to the specific area where they are experiencing the pain.)
  • How long have you been experiencing the pain? (Days, Weeks, Months, Years)
  • Did the pain begin suddenly (possibly following an injury) or has it developed gradually?
  • Describe the characteristics of the pain. (Aching, Burning, Stabbing, Throbbing, Dull, Sharp)
  • What time of day is the pain the absolute worst? (First step out of bed in the morning)
  • What makes the pain better or worse? (Activity vs. rest)
  • Have you ever had a similar condition before? If so, what helped it improve?
  • Have you tried any at-home treatments to provide relief? If so, what did you do and did it work?

My physical examination for Plantar Fasciitis is pretty straight forward.

I typically palpate (or feel) the bottom of the foot to locate the area of tenderness.

In addition, I will have my patient flex their foot and push along the plantar fascia band. Typically, pain is experienced during this in Plantar Fasciitis. I will then instruct the patient to point their toes. Pain generally subsides with this motion.

I also examine the area for any swelling or mild redness.

Lastly, I evaluate muscle strength and nerve health via testing the following:

  • Balance and coordination
  • Sense of touch
  • Reflexes

Radiographs (a.k.a. x-rays) and other imaging studies are rarely required for a diagnosis of Plantar Fasciitis unless they are utilized to rule other conditions out.

What About Plantar Fasciitis? – Final Thoughts

It is imperative to recognize and fully understand where your heel pain is coming from in order to quickly implement the most efficient means of treatment to eliminate your pain.

I truly hope that I helped you either confirm or eliminate your suspicion of Plantar Fasciitis involving you or your loved one.

As always, I welcome any comments below including either questions or your experience with this condition. I truly am here to help!

Your Online Foot Expert,

Dr. Misty

Podiatric Physician and Owner/Creator of

Child playing catcher in baseball for post How to Treat Heel Pain

How to Treat Heel Pain – Get Back in the Game

Heel pain in children is NO joke! When your child is in pain, it just plain hurts you too.

In this article, I will thoroughly discuss exactly how to treat heel pain and get your child back into their game as quickly as possible.

Child playing catcher in baseball

Because Sever’s Disease is the most common cause of heel pain in children, I will focus on the specific treatments that I utilize to nip this particular condition in the bud, but the recommendations outlined below will definitively aid in heel pain no matter the specific cause.

To read more about the signs and symptoms of heel pain in kids, feel free to read either (or both) of the following articles: “Heel Pain in Kids – Everything You Need to Know” and/or “Sever’s Disease in Children – Is It Affecting Your Child’s Game?“.

Onto what you are here for… let’s talk treatment!!!

A Quick Overview on How to Treat Heel Pain

It is all too familiar… a concerned parent bringing their child to my office with the complaint of heel pain and the fear that little Johnny is doomed from becoming the “next great thing” in his sport of choice because of it.

No fear… Dr. Misty is here!

There ARE ways to efficiently “knock-out” this burdensome pain once and for all and I am here to lay them all out on the table. I will tell you (in detail) exactly how I successfully treat my little patients that come in with this particular complaint.

I utilize the methods outlined below day-in and day-out to get kiddos with heel pain back on their feet:PICTURE OF HAPPY FEET

  • Rest
  • Ice
  • Oral Medication
  • Stretching
  • Shoe Inserts
  • Casting

Let’s talk about these in further detail…

Rest – The Dreaded Word

No child (or parent for that matter) wants to hear the dreaded word “REST”, but I could not write an article concerning how to treat heel pain without addressing it.

So… here it goes!

Rest is FREE and is one of the best ways to go about combating your child’s pain. It can take many shapes and forms and can include total rest to merely activity modifications.

Because Sever’s Disease doesn’t cause any long-term foot problems AND it will eventually go away on its own, temporarily stopping a sport, or reducing intensity, duration, and frequency, will definitely aid in the total elimination of your child’s heel pain.

However… I AM a realist as a physician AND I have treated my own son’s heel pain and I KNOW that for the aggressive athlete “rest” is sometimes not an option.

For this reason, I will leave this here and move on to more fluid ways to combat heel pain in children! ((:

Don’t Forget the Ice

You hear it quite frequently, but just how exactly does ice help with conditions such as heel pain?

Icing an injured area actually works to decrease tissue metabolism thereby reducing the amount of secondary muscle damage and edema (or swelling) of the area. In addition, ice is a great analgesic because it slows down the velocity of nerve conduction.

Simply put… ice decreases inflammation (or swelling) AND aids in reducing pain of a particular area (in our case the heel)!

So how do you effectively ice the heel?

I typically recommend icing the heel for 15 minutes at a time. You want to make sure that the ice is not in direct contact with the skin (to avoid frostbite) by applying a barrier, such as a towel, in between the skin and ice. To be most effective, this needs to be performed every 1-2 hours and ALWAYS directly following participation in an event.

Because it is physically difficult to hold (or balance) ice onto the heel area, products have been created for this purpose. One of my favorites, which I ALWAYS recommend for heel pain, is an Ankle/Foot Ice Therapy Wrap. Products such as these allow your child movement while therapeutically delivering the “cold” treatment that the area needs to heal.

Oral Medication – The Do’s & Dont’s

While I am NOT a huge advocate of “pill-popping”, there are certain times that I do recommend the use of oral medications (when they are not contraindicated) for particular conditions.

We do NOT like to see our babies in pain. If something can help relieve it… let’s do it!

When talking about the implementation of medications in our treatment of heel pain, all medications are NOT equal!

As long as your child has no medical conditions that prevent them from taking what we call non-steroidal anti-inflammatories (a.k.a. NSAIDs), this is my go-to for heel pain. These are common household, over-the-counter medications such as Ibuprofen, Motrin, and Aleeve.

NSAIDs far exceed acetaminophen (Tylenol) for the treatment of heel pain because they not only provide relief of pain, but they also work to block the production of certain chemicals by the body that cause inflammation.

When I recommend these medications for a child with heel pain, I typically instruct the child to follow the directions that come with the medication on how much and how often. I DO recommend taking the medication regularly for 48 hours and then as needed for pain.

How to Treat Heel Pain with Stretching

Stretching is critical in the treatment of heel pain in children.

To better understand, let’s quickly review the reasons that conditions, such as Sever’s Disease, cause pain.

Our children undergo rapid growth spurts. When these “growth spurts” occur, their heel bones develop more rapidly than the surrounding muscles and tendons. This results in a tightening of these muscles and tendons which pull directly on the heel bone thus causing pain and inflammation. To read more on this, visit my article titled, “Sever’s Disease in Children – Is it Affecting Your Child’s Game?”.

How can we help relieve this pain? Simple… let’s stretch it out!

Stretching acts to not only strengthen our muscles, but also to promote flexibility… flexibility that our children need more of when suffering from conditions such as Sever’s Disease.

Before I go into my three favorite stretches for heel pain, I do want to mention that any stretching exercise should ONLY be performed when NO ACUTE PAIN is present. Stretching while significant pain is present will only increase the pain thus being counter-productive.

Now… on to the BEST stretches for heel pain in kids! These stretches should be performed together at a minimum of five times per day. It is AMAZING what these simple stretches will accomplish!

The Active Stretch

Active stretch for how to treat heel pain

Begin stretching exercises with active stretching. This prepares the muscles for a rigorous treatment.

Simply have your child SLOWLY pull the foot and toes in an upward direction to stretch the muscles of the calf. This is best performed while sitting with the legs straight out in front of them and can be performed with or without the use of bands.

Ensure that your child is performing this very gently and controlled as sudden jerking motions may lead to intensified and prolonged pain.

Repeat this stretch at least five times prior to continuing on to the next stretch.

The Gastrocnemius Stretchgastrocnemius stretch for how to treat heel pain

Following the active stretch, focus should then be moved onto the gastrocnemius muscle which is along the calf area on the back of the leg.

Have your child stand facing a wall with their toes pointed towards the wall. Instruct them to lean forward towards the wall bracing the palms of their hands onto the wall. It is important to ensure that they do not raise their heels while performing this stretch. This position should be held for 45 seconds and repeated three times per stretching session.

Should your child not feel a stretch along the back of their legs, have them move their feet farther from the wall and repeat.

The Soleus Stretch

The soleus muscle is located on the lower half of the back of the leg.

To perform this stretch, have your child stand in front of a wall with their nose touching the wall and the toes of both feet up on the wall. Next, instruct them to bend the knee until a stretch is felt in the lower leg and back of the heel. Hold for 45 seconds and repeat three times.soleus stretch for how to treat heel pain

Shoe Inserts – A Must Have

If you speak to any physician regarding Sever’s Disease… you are going to hear one word (actually two)… heel cups!heel cups for how to treat heel pain

Heel cups are the standardized treatment for heel pain in children and provide two distinct benefits:

  1. Restrict any excessive motion of the heel
  2. Provide shock absorption in order to dissipate some of the ground forces felt throughout the heel

These two things together work fluidly to reduce the stress on the heel bone.

There is no question that heel cups are essential (I won’t waste your time on the science behind them), but how do you know which heel cups are best?

If you google “heel cups”, you will see thousands of results… feel free to try it! However, I am here to help you so I can tell you what the best heel cups on the planet are! Save your time and $$$.

I ALWAYS recommend Tuli’s Heavy Duty Heal Cups to my adolescent patients suffering with heel pain and they are NEVER disappointed. These heel cups are the ultimate product for heel pain relief and are the #1 Podiatrist-recommended heel cups in the world. Need I say more?

When you are treating your child’s heel pain with heel cups, it is essential that you have your child wear them inside of their shoes at all times. Don’t worry… no one will even see that they are there!

In addition, according to my patients (one of whom was my son), they are much more comfortable when worn underneath the sole of the shoe.

Heel cups are NECESSARY!

Casting – The Rarity

I would say that 95% of heel pain in children can be cured by combining rest, ice, anti-inflammatory medication, stretching, and heel cups, but for completeness’ sake, I felt the need to mention casting or immobilization as a means of treatment.

IF you have faithfully tried all the above with your child and they STILL complain of significant pain then it is definitely time to visit a physician.

It is a rarity, but sometimes, in extreme cases, casting is necessary to fully rid of your child’s pain.

How to Treat Heel Pain – You NOW Know

I sincerely hope that you see by now that your child’s heel pain is nothing to ignore and I have given you the tools that you need as a parent to successfully eliminate their suffering.

Remember… rest, ice, oral NSAIDs, stretching, and heel cups are critical to implement upon the first complaint of pain! You will be in awe of the success of these modes of treatment.

I appreciate you reading this article and I know that it will help!

As always, should you have any questions regarding any of the information presented here, please feel free to comment below. I am here to help!


Dr. Misty

Podiatric Physician and Owner/Creator of

X-Ray of Growth Plate on Heel for Post Sever's Disease in Children

Sever’s Disease in Children – Is It Affecting Your Child’s Game?

You are here because you are wondering if either your child, or the child of someone you know, has a condition called Sever’s Disease.Picture of lady thinking

Am I right?

With Sever’s Disease being the #1 cause of heel pain in children, it is IMPERATIVE that you read the information provided below so that you can determine exactly what is affecting your child’s game and treat it!

Sever’s Disease in children is NO JOKE, and here, I will detail (very simply) exactly what this impairing condition is in order for you to feel confident about what is impeding your child from excelling!

Let’s Talk About Bones

To fully understand Sever’s Disease (also known as Calcaneal Apophysitis), we must understand a little bit of basic knowledge surrounding bones in general.

We all have bones in our bodies… 206 to be exact!Skeleton of Body for Post Severs Disease in Children

Our bones have a purpose and that purpose is to form the shape of our bodies and allow us to move around.

Because we are tiny little things when we are brought into this world and eventually develop into adult-sized creatures over time, our bones MUST have the ability to expand with us. This massive expansion of our bones is made possible by something called growth plates.

Every single bone has a growth plate (also called the epiphysis) and they are exactly what they sound like… the area within a bone that allows the bone to grow.

Once a bone grows to its adult size, these growth plates close and become solid bone, but during growth (while the growth plate still exists), these areas are more fragile and are at greater risk for injury.

Enough about bones…

So… What is Sever’s Disease?

You reached this page due to a google search on “Sever’s Disease in children” or something similar. But… what is this condition really about?

You have probably figured out by now that it has something to do with bones and growth plates and you are correct!

Let’s discuss…

Sever’s Disease in children is definitely NOT a disease as it sounds but actually an injury.

The foot is comprised of 26 bones one of which is the heel bone (calcaneus). Look at the x-ray below of the adult foot… pay attention to the heel!

X ray of adult heel for post severs disease in children

Guess what? The heel bone has a growth plate! This particular growth plate (in the heel) is called the Calcaneal Apophysis and is actually one of the first in the body to reach adult size and close.

Below is an x-ray of a child’s foot. See the growth plate on the heel?

x ray of growth plate on heel for post severs disease in children

Sit tight… this is where Sever’s Disease comes in!

Because the calcaneus (heel bone) grows faster than most other bones in the body, quite often the muscles and tendons that connect to it (and are growing also) just can’t keep up. When this occurs, the tendon attached to the back of the heel becomes very tight and pulls on the heel.

Picture of tendon pulling on heel for post Severs Disease in Children

Couple this tightness of the tendon pulling on the heel around the area of the growth plate with added strain from sports or other strenuous activities and boom… you get Sever’s Disease in children!

So… in a nut shell, Sever’s Disease is when the growth plate of the heel bone becomes irritated and inflamed due to a tight tendon pulling on the area.

Is Age a Factor with Sever’s Disease in Children?

You can probably answer this question on your own by now, but YES… age is definitely a factor in determining the risk for sign-with-puberty-for-post-severs-disease-in-childrenSever’s Disease in children.

As stated above, Calcaneal Apophysitis (Sever’s Disease) has a direct correlation with puberty… when our bodies are growing their fastest.

So… because girls hit puberty first, we tend to see this condition diagnosed in them when they are around the ages of 8-13.

Boys, on the other hand, typically have later growth spurts and can be anywhere between the ages of 10-15 when and if they develop Sever’s Disease (which is much more common in boys vs. girls).

Typical Signs & Symptoms of Sever’s Disease

Do you still think that Sever’s Disease could be your child’s problem?

If your child is between the at-risk ages for their sex (noted above), is involved in extra-curricular activities that consist of running, pivoting, and jumping on hard surfaces, and has recently been complaining of heel pain, take a look at the common signs and symptoms associated with Sever’s Disease in children noted below to see if this condition could be the culprit.picture-of-painful-heel-for-post-severs-disease-in-children

  • pain, mild redness, and/or swelling in one or both of the heels
  • difficulty walking due to pain in one or both feet
  • limping and/or walking on tiptoes in an attempt to lessen the pain felt with each step
  • intensifying pain upon squeezing both sides of one or both heels
  • pain in one or both heels that increases during an activity that involves running or jumping and improves upon rest
  • complaints of a stiffness felt in the feet when first waking up in the mornings

Often times we see the development of Sever’s Disease in children that are beginning a new sport OR those who are starting a new season after a break from the sport.

Diagnosing Sever’s Disease in Children

If you are STILL pretty positive that your child is suffering from Sever’s Disease, what is your next step?picture-of-doctor-for-post-severs-disease-in-children

As expected, I ALWAYS recommend a visit to a podiatric physician (such as myself) or your child’s pediatrician for a verified diagnosis.

At your appointment, you can expect your physician to review your child’s medical history and discuss any changes in recent activity. In addition, your child’s doctor should perform a thorough medical examination of the feet and legs. Radiographs (x-rays) may also be performed to rule out any structural deficiencies or other conditions affecting your child’s foot.

That’s a Wrap

I hope that I have done a good job aiding in your understanding of Sever’s Disease in children… that was my goal (just in case you didn’t know).

The main take-away that I would like you to hold onto is that Sever’s Disease is the #1 cause of heel pain in children, not Plantar Fasciitis (which is the #1 cause of heel pain in adults).

Treatment options for Sever’s Disease do exist and you can read more about them in my article titled “How to Treat Heel Pain – Get Back in the Game“.

If your child is experiencing heel pain, it is essential to determine the cause in order for proper treatment to be implemented in a timely fashion. Hopefully, my article was able to either validate or eliminate Sever’s Disease as the culprit of your child’s pain.

To read about other causes of heel pain in children, CLICK HERE!

As always, I am here and willing to help you. If you have any questions, please feel free to drop a comment below and I will get back with you. In addition, myself (as well as my readers) would love for you to comment on any experience that you have had regarding Sever’s Disease below.

Your Online Foot Expert,

Dr. Misty

Podiatric Physician and Owner/Creator of

Picture of boy resting feet for post heel pain in kids

Heel Pain in Kids – Everything YOU Need to Know

Heel pain in kids is an increasingly common complaint amongst the youngsters of today’s Heel Pain in Kids with Boy Cryingsociety. Often times parents will mistakenly contribute this type of pain to merely “growing pains” and either ignore their child’s cries OR wait to implement treatment believing that this pain will eventually “go away” on its own.

In this article, I will examine heel pain in kids via discussing the symptoms, difference of this pain in adults versus children, causes, diagnostic modalities, treatment options, and prevention.

Common Signs & Symptoms of Heel Pain in Kids

For clarification purposes, I feel it is essential to state that heel pain is NOT a diagnosis nor disease within itself, but rather a symptom. Having this pain potentially indicates that an underlying disease or injury exists.

When a child complains of heel pain, this should alert the parent that a condition is present that deserves their attention.

Signs and symptoms commonly associated with heel problems in children include:

  • Pain in the bottom or back of the heelHeel Pain in Kids with Boy not Participating
  • Walking with a noticeable limp
  • Toe-walking or walking on the toes with body weight lifted off of the heels
  • Increasing desire to sit and “rest” when walking normal, everyday distances
  • Decreasing desire and difficulty participating in usual sporting events and/or activities.

The Difference Between Heel Pain in Kids & Adults

The unknowing parent may inaccurately self-diagnose their child’s heel pain as a condition called Plantar Fasciitis. With a simple google of “heel pain”, hundreds of articles will discuss Plantar Fasciitis as the most common cause of heel pain. However, there is a HUGE difference regarding the cause of heel pain in kids versus that of adults.

Plantar Fasciitis, usually seen in adults, results in pain within the heel that is most prevalent on the first step out of bed in the mornings or when taking a step after an extended period of sitting down. This pain typically improves in intensity upon walking short distances.

Oppositely, heel pain in kids usually feels better after rest and the intensity of the pain is noticed to increase upon walking and activity.

Why is this?

A child’s bones have what we call growth plates, also known as the epiphysis. This area is the location that new bone forms as the child grows until the particular bone reaches its adult size.

picture of growth plate of heel for post heel pain in kids

The epiphysis of the calcaneus (heel bone) is an area that doesn’t fully develop until a child is around 14 years of age or older. This growth plate is located on the back of the heel and is very weak until it becomes adult-sized.

Excessive stress on this area of the heel bone is the primary cause of heel pain in kids.

Causes of Heel Pain in Kids

Because there are a multitude of causes of heel pain in kids and the diagnosis can be quite challenging, a visit to a podiatric physician (like myself) is recommended to determine the cause of the pain and implement an effective mode of treatment.

Some of the most common causes of pediatric heel pain include the following conditions.

Sever’s Disease

Also referred to as Calcaneal Apophysitis, Sever’s Disease is the #1 cause of heel pain in kids.

Misidentified as a “disease”, this condition is actually a result of inflammation occurring within the growth plate of the heel bone. This inflammation is commonly witnessed in our young athletes or obese children due to repetitive stress and muscle strain to the area before the calcaneus (heel bone) is fully formed.

Calcaneal Apophysitis can occur in both feet or just one foot.

Picture of severs disease for post heel pain in kidsThe signs and symptoms associated with this condition tends to include some or all of the following:

  • Tenderness and pain along the back of and/or bottom of the heel when ambulating
  • Pain or tenderness upon a simple touch to the heel that increases when the heel is squeezed
  • Pain in the heel that is intensified by activity and improves with rest
  • Swelling or redness in one or both heels
  • Ambulating with a limp or toe-walking (walking on tip toes)

If interested in learning more about Sever’s Disease, please visit the following two links:

Sever’s Disease in Children – Is it Affecting Your Child’s Game?

How to Treat Heel Pain – Get Back in the Game

Tendo-Achilles Bursitis

There is a natural bursa, fluid-filled sac, located directly between the back of the heel bone and the Achilles Tendon (heel cord). Certain things can cause this bursa to become inflamed. When this occurs, we refer to the condition as Tendo-Achilles Bursitis.

The inflammation of this particular bursa can be a result of multiple scenarios including, but not limited to, direct injury to the heel, inflammatory diseases (such as Juvenile Rheumatoid Arthritis), or even simply wearing shoes that are poorly cushioned where the shoe touches the back of the heel.

picture of achilles bursitis for post heel pain in kidsSymptoms frequently seen with Tendo-Achilles Bursitis can include the following:

  • Tenderness and pain isolated to the back of the heel
  • Pain along the back of the heel that is intensified by walking, running, or standing on tip-toes
  • Warmth and/or area of redness seen on the skin on the back side of the heel area
  • Pain along the back of the heel that is aggravated by wearing shoe gear that rubs the particular area the pain is present

Achilles Tendonitis

Achilles Tendinitis is a condition that we often term as an “overuse syndrome”.

This diagnosis often results in those over the age of 14 (heel bone is fully developed) and is caused by the repetitive nature of running and pounding on hard surfaces usually in sports such as basketball, soccer, and track among others.

picture of achilles tendinitis for post heel pain in kidsSymptoms associated with Achilles Tendinitis include some or all of the following:

  • Pain just above the back of the heel and lower portion of the leg
  • Pain that intensifies with activity and pointing of the toes and improves with rest and the foot in a relaxed state
  • Soreness and stiffness in the back of the heel area that is worse upon rising in the morning
  • Pain along the back of the heel that is aggravated by wearing shoegear that rubs the back-side of the heel.

Plantar Fasciitis

Also categorized as an “overuse syndrome”, Plantar Fasciitis is most commonly seen in adults, but can be seen in children, typically over the age of 14.

The plantar fascia band is a band of tissue that spans the bottom of the foot from the heel all the way to the toes. When this band becomes inflamed, usually due to obesity or overuse, this is termed Plantar Fasciitis.

picture of plantar fasciitis for post heel pain in kidsSymptoms frequently seen with Plantar Fasciitis may include some or all of the following:

  • Sharp pain on the bottom of the heel
  • Pain on the bottom of the heel is most intense on the first step out of bed in the morning and improves some upon walking a bit
  • Pain that increases when standing for extended periods of time


Heel pain in kids may also be the direct result of a fracture (break in the bone). There are two types of fractures (stress fracture and acute fracture) that should be ruled out when heel pain exists.

Stress fractures are typically witnessed in athletic adolescents whom suddenly undergo a change in the level of intensity of workouts.

Acute fractures are seen in a direct injury to the area. Pain and swelling can be immediately correlated to the time of injury.

Diagnosis of Pediatric Heel Pain

A visit to your local podiatrist or other medical professional is essential to diagnose the underlying cause of heel pain in your child.Picture of Foot Exam for Post on Heel Pain in Kids

The examination will begin with questions surrounding your child’s recent activity as well as their medical history. A thorough physical exam of the foot in its entirety as well as the leg will then ensue. Radiographs (x-rays) will often follow and will be utilized to evaluate the bones and structure of the foot as well as to determine the maturity of the bones and whether growth plates are still open.

In some cases, additional studies such as an MRI (Magnetic Resonance Imaging), CT Scan (Computerized Tomography), bone scans, or laboratory testing may be ordered or performed to further assist an accurate diagnosis for the heel pain.

Treatment Options for Heel Pain in Kids

Obviously, the treatment for pediatric heel pain needs to be approached in a manner that eliminates, adjusts, or fixes the root cause of the pain.

Most of the time, treatment modes for heel pain in kids is approached by the level of intensity of the pain and broken down into categories of mild, moderate, and severe pain.

Mild Heel Pain in Kids

  • Reduction in Activity. Immediately stop or reduce whatever activity is generating the pain until the pain no longer exists.
    Picture of boy resting feet for post heel pain in kids
  • Heel Cushions. Implement an added cushion within the shoe which will soften the impact upon the heel when walking or participating in activities. I have found the most success and my pediatric patients rant and rave over the Tuli’s Heavy Duty Heel Cups!

Moderate Heel Pain in Kids

With moderate heel pain, you will want to execute the treatments listed above for mild heel pain in addition to the following recommendations.

  • Medication. Administer ibuprofen or other oral NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) to aid in the reduction of pain and inflammation.
    Picture of Medicine for Post Heel Pain in Kids
  • Physical Therapy. Stretching exercises and/or other modalities of physical therapy may be utilized in order to promote healing of the area(s) of inflammation. Icing the area is a very beneficial form of physical therapy although the heel is a hard area to adequately ice. The ProIce Ankle/Foot Ice Therapy Wrap makes icing the heel a breeze and is what I, personally, recommend to my patients.
  • Orthotics. Often times orthotic devices that are prescribed by your podiatrist and are custom-made for your child’s foot are recommended. The goal behind the use of orthotics is to provide support for the feet and redistribute the ground reaction forces that act upon the joints of the feet while weight-bearing.

Severe Heel Pain in Kids

  • Immobilization. Sometimes, with severe heel pain, aggressive measures such as Picture of Foot in Cast for Post Heel Pain in Kidsimmobilization of the area needs to be implemented in order for the condition to fully resolve. Immobilization may entail either becoming non-weightbearing via the use of crutches or casting. Following the immobilization period, orthotic devices and/or physical therapy modalities are usually implemented to ensure the condition does not return.
  • Surgery. While uncommon, there are times when surgical correction is recommended. This is typically reserved for structural abnormalities within the foot and/or the tendons within in.

For more specific information regarding the treatment of heel pain, feel free to go to my article titled “How to Treat Heel Pain – Get Back in the Game“.

Prevention of Heel Pain in Children

While nothing can 100% guarantee that your child will never develop heel pain, there are certain actions that can be taken to be proactive and minimize their risks.

Some ways to prevent adolescent heel pain include the following:

  • Avoid childhood obesity
  • Purchase shoegear that is well-constructed and provides support to the feet
  • For athletes – Ensure that shoegear worn is appropriate for the particular sport or activity and limit the amount of time that cleated shoes are worn
  • Do not push your child above and beyond their individual physical ability

Take Away on Heel Pain in Kids

Typically, it is the nature of a child to be active and desire to participate in extra-curricular Picture of child playing soccer for post heel pain in kidsevents.

When an adolescent complains of heel pain and it becomes evident that this heel pain is beginning to influence their participation in the usual activities, it is time to take action to determine the cause of the pain and implement the appropriate treatment.

Heel pain in kids is nothing to be ignored and with the proper diagnosis and treatment modalities, a parent can easily have their child pain-free and enjoying life again.

I sincerely hope that you found my article informative and that it will help you to alleviate your child’s heel pain.

If you have ANY questions, or even personal experience with heel pain involving your kids, please feel free to comment below. I am here to help!

Your Online Foot Expert,

Dr. Misty

Podiatric Physician and Owner/Creator of