My Child Is Complaining of Heel Pain

What Is Causing It and How Can I Help Them?

By Dr. John Goodner

Dr. Goodner is a Board Qualified
Reconstructive Foot & Ankle Surgeon
specializing in sports medicine foot and
ankle injuries, arthroscopy, trauma &
deformities in patients of all ages.

Painful inflammation to the growth plate (calcaneal apophysis) in the back of the heel is know as Sever's Disease. This ailment is most common in young soccer, baseball and basketball players due to the cleat patterns on shoes for these sports along with the specific demands these sports place on the heel region.

Why is my child having heel pain?

This type of heel pain typically occurs after overactivity in children between the ages of eight and fourteen. Tight muscles in their lower extremities, especially the calves and hamstrings, are usually to blame for the pain's onset. 

Many children who experience heel pain like this have associated flatfeet as well. Growth spurts can aggravate the condition further due to your child's body trying to adjust to the increased tension from already tight muscles on the calcaneal apophysis. Poor shoes or walking barefoot on hard surfaces can aggravate the heel's growth plates as well.

How do I know if my child has Calcaneal Apophysitis (Sever's Disease)?

• Your child will display discomfort in the heel bone at the end of an activity. 
• You will typically see stiffness in their foot in the morning and pain while walking. 
• Their pain will be alleviated by rest and a decrease in activity.
• Stiffness and pain will usually present after a child is done with activity, sits for a period of time and then tries to get up and walk.
• Tenderness to the back, sides and bottom of the heel from touch or grasping of the heel.
• You may notice your child walking on the ball of their foot to avoid touching their heel to the ground.
• Discoloration and swelling likely won't be seen.
• Limping at the end of activity that persists as the condition worsens is another sign.

How can my child's pain get better?

There is always a need to modify or avoid activities that aggravate the injury and avoid going barefooted. Taping the foot to decrease pulling on the plantar fascia is a good relief option. Proper shoes along with heel lifts can decrease pressure and tension on the heel.

Night splinting to stretch tight calf muscles and arch ligaments can maintain flexibility gained from calf stretching. Custom molded orthotics are necessary to support the foot and help to restore proper alignment in cases where flat feet contribute to the heel pain.

Physical therapy to improve flexibility and diminish inflammation of the growth plate may be necessary if symptoms persist after these home care options and activity modification do not work. Occasionally, immobilization in a cast or brace to completely rest the heel and allow healing may be necessary. 

Prognosis is excellent in most cases when a treatment plan is followed.

Use our online scheduler to book your appointment! If you have a busy schedule during the week, we are open Saturdays by appointment only in our recently redone Plantation office.

Click here to book your appointment and get your child back to their best!

Heel & Arch Pain in Adults - A Quick Fix for Foot Specialists

What is Plantar Fasciitis (Heel Spur Syndrome)?

PROBLEM

Are you suffering from heel or arch pain?
Why not fix it with our Foot, Ankle & Leg
Specialists today?

An inflammation of the main ligament in the arch of your foot, where it attaches to the heel bone and supports the foot, can lead to pain in the bottom of the foot. Usually, this pain will be diagnosed as plantar fasciitis, or heel spur syndrome.

CAUSES

• Trauma, or other injury, to the bottom of the foot.
• Excessive activity or use over a short period of time.
• Flat or high-arched feet.
• Tight muscles, especially the calf or hamstring.
• Poor footwear (either flat or worn-out shoes) or walking barefoot for prolonged periods of time.
• Standing or walking on hard surfaces for prolonged periods of time.
• Uphill walking on a treadmill.
• Overuse of the elliptical machine.
• Excessive calf raises or lunges.
• Zumba type classes that make you change elevation frequently during exercise.

SIGNS & SYMPTOMS

• Pain first thing in the morning when you get out of bed and put weight on your foot.
• Pain that diminishes while walking. Pain that may last for only a few minutes early on, but persists for longer durations as time passes.
• Pain after sitting for a prolonged period of time or when getting out of a car and starting to walk.
• Occasional burning, numbness, shooting or tingling in the heel. This may also be a sign of surrounding nerve injury.
• Extreme tenderness when touching the heel or arch area on your foot.
• Commonly seen with lower back pain.
• Potential degradation to stress reaction or stress fracture in the foot or leg.

TREATMENT

As painful as plantar fasciitis may be, it's actually very easy to treat if you see a foot specialist early. Here's what to expect from treatment. First, you'll go through a thorough history and physical examination of the foot and lower leg. Then, based on the findings, you'll likely be told one of the following.

• Avoid walking barefoot. Wear a supportive shoe with a heel higher than the front. For women, high heels an inch or larger work best. This takes much of the pressure off of the affected area.
• Anti-inflammatory medication, ultrasound-guided steroid injections or oral medications, will be prescribed to help reduce inflammation.
• Taping your foot to support and give immediate relief to the area.
• Prescription of custom molded orthotic inserts to permanently support your foot and prevent reoccurrence. This is always the best LONG-TERM treatment for plantar fasciitis.
• Frequent stretching of calf and hamstring muscles to improve your overall flexibility.
• Splinting your foot at night to stretch the muscle in the back of the leg.
• Applying ice to the area by freezing an almost full plastic water bottle and rolling it with the arch of your foot.
• Occasional immobilization of the foot in a cast or boot to provide more rest and immediate relief.
• Shockwave therapy or PRP (platelet rich plasma) injections.
• Surgery as a last resort. Endoscopic plantar fascia release of the ligament from the heel is a 10 minute procedure that provides relief in almost all cases.

PROGNOSIS

Long term relief is almost guaranteed when you treat your plantar fasciitis early. A diligent approach to treatment is always best, and when our patients work with us to make that happen, we are able to provide almost immediate relief in most cases.

Use our online scheduler to book your appointment. If you have a busy schedule during the week, we are open Saturdays by appointment only in our recently redone Plantation office. 

Click here to book your appointment and get yourself back to your best!

5 Common Foot & Ankle Injuries in Youth Athletes

Different Effects, Same Goals - Healthy Kids!

Parents should encourage their children to participate in sports. Not only will they gain cardiovascular benefits, but sports also helps to develop attributes like self discipline, teamwork and an appreciation of the importance of good health habits that they will carry throughout their lifetime. In children younger than 10, we believe in multi-sport participation with a training emphasis on proper technique and coordination.

     

We advise that sport specialization be delayed until late teenage years. Research shows that children who specialize too early are more likely to experience foot and ankle injuries. In addition to proper-fitting and supporting footwear, a dynamic warm-up specific to the sport being played is recommended for all ages in order to prevent injury. 

Differing from adults, children are more susceptible to growth plate injuries rather than injuries to tendons and ligaments. These growth plates typically do not finish closing until 15-18 in boys and 13-16 in girls. Many children also suffer from torsional imbalances such as in-toe or out-toe; however, the majority them outgrow these conditions without medical treatment. Still, see a foot and ankle specialist if your child is consistently tripping during activity. It could be related to these imbalances.

Tibial torsion examples in children and youth athletes.

We've put together a list of five common foot & ankle injuries that we see in children that come through our offices, along with different treatments. As always, each case is unique, and we recommend seeing one of our experts if your child is suffering from one of these injuries.

Ankle Sprains

Ankle sprains are typically seen more often in older youth athletes. For younger athletes with the same injury, there tends to be associated growth plate injuries. Immediate treatment is critical to healing and prevention of long term ankle instability. Physical therapy to restore balance and strength is often necessary after offloading the injured ankle.

Pre- and post-operation photos of two types of ankle fractures.

Fractures

If a child is unable to put weight on the injured foot after injury, we recommend an x-ray to rule out a fracture. If the fracture itself is not severe, rest and immobilization with a cast may be enough to let it heal. More complicated injuries may require surgical correction for better long term prognosis. We often see stress fractures in children who participate in over 16 hours of sports practice and activity each week. A good rule of thumb to prevent stress fractures is to keep organized sport participation to fewer hours per week than your child's age in years. 

Heel Pain

Also referred to as calcaneal apophysitis, heel pain is likely caused by an inflammation of the growth plate in the heel from excessive usage, a tight achilles tendon, flat feet, poor fitting cleats or shoes, or blunt trauma. Commonly seen in sprinting sports, like soccer and baseball because of cleat patterns and in basketball from the repeated force when coming down after a rebound. Usual treatment includes rest, immobilization, ice, heel lifts, orthotics, stretching and physical therapy.

Shin Splints

Shin splints are a very common overuse injury. The presence of a tight achilles tendon can cause overuse and inflammation of the weaker dorsiflexion muscles in the front of the leg. In children with flat feet and a tight achilles, overuse of a muscle in the back inside of the leg can become inflamed as well. Treatment includes rest, ice, compression, physical therapy, stretching, strengthening exercises, and orthotics.

Our office is fully equipped and accepts Same Day Appointments for all Urgent/Emergent Foot and Ankle Injuries. If your child is suffering from a foot or ankle injury, save time and money from an expensive trip to Urgent Care or the Emergency Room, and please call the nearest office immediately.

Or, use our online scheduler to book your appointment. If you have a busy schedule during the week, we are open Saturdays by appointment only in our recently redone Plantation office. Click here to book your appointment and get your child back to their best!

Are Stem Cells the Answer to your Foot, Ankle and Leg pain?

Are Stem Cells the Answer to your Foot, Ankle and Leg pain?

     Many patients are avoiding painful and costly surgery by choosing Stem Cell Therapy. We have seen great results for:

Plantar Fasciitis - Heel Pain
Achilles Tendonosis
Tendinitis around the foot and ankle joints
Ankle and Foot Ligament Damage

      If you have had your pain for months, even years, why not try Stem Cells to reduce inflammation and the associated pain to your foot and ankle. Improve your pain and lessen your disability with the latest technology in regenerative medicine. Give yourself a chance to restore your foot and ankle range of motion and decrease the scar tissue formation from your chronic pain or old foot and ankle injury.

     Traditional treatments of repeated cortisone injections and Platelet rich plasma, can present with potential complications and sometimes unclear results. Stem Cell therapy can deliver safer and more reliable outcomes for patient's foot and ankle conditions.

      Go to our website, at SouthFloridaSportsMedicine.com and use the online scheduler to make your appointment at any of our three convenient locations in Broward. Our job is to get you back to your best. See you soon!

http://www.southfloridasportsmedicine.com/joint-lubrication.html