A Warning Sign

Surgeon Urges Prompt Treatment for Growth Plate Injuries

Indoors and outdoors, youth athletes stay active year-round in competitive sports, and for many of them heel pain has become “just another part of the game.” Foot and ankle surgeon, Daniel D. Michaels, DPM, MS, FACFAS, advises that when a child complains of heel pain, it should be diagnosed promptly because it may be a warning sign of a serious foot problem.  

Dr. Michaels says heel pain occurs frequently in children ages 6 to 14 as their feet grow and the heel bone develops. “As children become more active in sports they increase their risk for growth-plate injuries and subsequent heel pain,” says Dr. Michaels. This is especially true at back-to-school time when surgeons see an increase in middle and high school athletes experiencing heel pain with football and soccer seasons simultaneously underway.  

“New bone forms in an area behind the heel, known as the growth plate, and cartilage is vulnerable to severe inflammation from strain or stress. With repeated stresses and strains from overactivity, the heel becomes very painful,” Dr. Michaels explains.

Even though growth-plate trauma is the leading cause of heel pain in young people, Dr. Michaels says the condition can be difficult to diagnose. He cautions that parents should be concerned if a child has pain in the back or bottom of the heel, limps, walks on the toes, or seems to have difficulty participating in normal recreational activities. The condition is diagnosed by a thorough examination of the child’s feet and legs and possibly medical imaging tests to rule out other serious causes of heel pain, such as bursitis, tendonitis and fractures.

In most cases, mild or moderate heel pain can be treated successfully with shoe inserts to soften the impact on the heel, anti-inflammatory medications, stretching and physical therapy. In severe cases, the foot and ankle will be immobilized in a cast and, in some instances, surgery may be necessary.

Heel pain in young people often returns after treatment because the growth plate is still forming until the age of 14 or 15. However, the risk for recurrence can be lowered by choosing well-constructed shoes with good support and restricting use of spiked athletic shoes, especially on hard fields. It also is advised that young athletes avoid competition that exceeds their physical abilities.

For further information about foot or ankle conditions, contact one of our foot and ankle surgeons at the Reconstructive Foot & Ankle Institute, LLC.  Visit us on the web at www.rfainstitute.com or make an appointment with one of our state of the art offices in Maryland:

Hagerstown 301.797.8554, 1150 Professional Court, Suite C, 21740

Frederick 301.418.6014, 2100 Old Farm Drive, Suite D, 21702