Why Does My Child's Heel Hurt After Running or Sports?

Children's Heel Pain and Sports

This article discusses common (and not so common) causes of heel pain in children that play sports using real life statistics and expert collaboration with pediatric podiatrist, Dr. Mikkel Jarman.


Children, Sports, & Heel Pain.

Sports play an important role in the lives of children. The benefits are numerous including physical, mental, social, character development, leadership developement, self-esteem, team work, and more! However, with increased physical activity comes an increased risk for injuries. And among those injuries, foot injuries are quite common. One particular issue that arises is heel pain.

Key Takeaways

Here are 12 key takeaways:

  1. Children that play sports are more susceptible to foot injuries and heel pain.
  2. Among young athletes, the most prevalent cause of heel pain is Sever’s Disease. 
  3. Sever’s disease (aka Calcaneal Apophysitis), is a condition that affects children ages 6 to 16, causing a pronounced, sharp pain in the heel associated with the development of the child’s growth plate.
  4. For an unofficial diagnosis of Sever’s, lightly squeeze the sides of the child’s heel (watch this video).
  5. The activities most frequently linked to Sever’s disease heel pain in order are: Soccer, Basketball, Gymnastics, Baseball, Football, and Running.
  6. The most common age range of children most affected by heel pain due to Sever’s disease is ages 8 – 13.
  1. Statistically, boys are more likely to experience Sever’s disease than girls (72% of boys vs. 28% of girls as reported by Mikki Device User Statistics).
  2. There are 2 types of Sever’s disease; Acute and Chronic
  3. Acute Sever’s generally resolves on its own responding favorably to conservative treatments (A Pediatric Night Brace can help is sometimes recommended).
  4. Chronic Sever’s is less likely to resolve on its own and the recommended treatment is often custom orthotics and a nighttime pediatric brace.
  5. The Mikki Device is an at home treatment specifically designed to treat chronic Sever’s disease.
  6. It’s important that coaches, parents, and any other caregivers are familiar with Sever’s disease in children. and aware of how to recognize the signs. 

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Causes of Heel Pain in Active Children

While Sever’s disease is the most common cause of heel pain in active children (95% of the time), it is not the only cause of heel pain. The other 5% could be caused by other conditions.

Here are some potential causes including Sever’s disease:

  • Sever’s Disease: Severs Disease is a common source of heel pain or discomfort among children and teenagers, especially those who engage in physical activities or sports. This condition arises from the inflammation of the growth plate, in the heel typically brought on by strain and impact endured during running and jumping exercises.
  • Tarsal Tunnel Syndrome: This condition arises from compression of the nerve within a narrow passage called the tarsal tunnel located inside the ankle. Symptoms may include pain and numbness experienced in the heel and sole of the foot. Although more prevalent among adults it can also affect children or those who have suffered an injury.
  • Stress Fractures: These are cracks that develop in a bone over time as a result of stress caused by repetitive force – common in activities like frequent jumping or long distance running. Stress fractures in the heel bone (calcaneus) can lead to heel pain in children.
  • Tarsal Coalition: The tarsal bones are located at the pinnacle of the arch, heel, and ankle of the foot. A tarsal coalition refers to an unusual linkage between two or more of these bones. Such coalitions may develop across joints in a child’s foot or even between bones that typically don’t share a joint.
  • Achilles Tendinitis: This condition occurs when the Achilles tendon, the tissue that connects the calf muscles to the heel bone is strained due to use. It is commonly seen in athletes who participate in sports involving running and jumping.
  • Flat Feet or High Arches: Children who have feet or high arches may experience foot pain, including discomfort, in the heels. This is because these conditions can impact the alignment and balance of the feet, which in turn puts strain on the muscles and ligaments of the foot.
  • Bursitis: Bursitis refers to inflammation of a bursa, which’s a sac filled with fluid that helps cushion and reduce friction between tissues, in our body. Several bursae surround the heel area. If any of them become inflamed it can result in heel pain. Overuse or direct impact can lead to bursitis in the heel region.

**It is important to note Mikki Device orthotics are not directly utilized to resolve symptoms associated with these conditions. However, they will indirectly improve the symptoms the child is experiencing.

Mikkel C. Jarman, DPM, FACFAS

"As a Pediatric Podiatrist, I diagnose and manage a wide range of pediatric foot conditions, encompassing various types of heel pain. Among these, particularly in young athletes, Sever's Disease is overwhelmingly prevalent, accounting for over 85% of such cases."

Sever's Disease - The Diagnosis

Sever's Disease - The Treatment

Identifying Sever's Disease

How to identify if your child has Sever's disease and the two types.

Acute vs Chronic Sever's

Sever’s Disease can appear in two forms. Acute and chronic each with their own unique characteristics and treatment methods.

Acute Severs Disease: This type of Sever’s usually occurs suddenly where a child feels a pain in their heel during or after physical activity. The inflammation is typically caused by excessive use or high impact activities. Conservative treatments like rest applying ice and using over the counter pain relievers often work well for managing acute Severs Disease. In cases a Pediatric Brace may be recommended to provide extra support and relieve discomfort.

Chronic Sever’s Disease:  Chronic Sever’s on the other hand is a persistent inflammation of heel’s growth plate that does not easily subside. This prolonged condition can manifest as increased pain, persisting for months, or in some instances, even years. It is highly advisable to seek treatment for Chronic Sever’s Disease, which often involves a comprehensive approach that combines custom orthotics and a nighttime pediatric brace for optimal outcomes.

How to Check for Sever's

In this video Dr. Jarman demonstrates how he performs a check for Sever’s in office. While this demonstration can help in identifying Sever’s, there may be situations where an X-ray at the office is required to rule out any other possible conditions. It’s important to note that this demonstration is not a substitute for an official diagnosis. For an official diagnosis it is always advised to seek guidance from a licensed pediatric podiatrist.

Play Video about Identifying Sever's Disease with Dr Mikkel Jarman

The Connection Between Sever's Disease and Certain Sports

Some sports tend to have a higher incidence of Sever’s Disease, especially ones involving running, kicking and jumping. The most common sports linked to Sever’s are:

  1. Soccer,
  2. Basketball,
  3. Gymnastics
  4. Baseball,
  5. and Football

Top 10 Sports Linked to Sever's Pie Chart

(This pie chart data and other valuable statistics were obtained from a dataset parents who ordered Mikki Device orthotics to address their children’s heel pain.)

Most Common Sports Linked to Sever's

(In order, here are the top sports reported by parents with children experiencing heel pain from Sever’s disease.)

  • Soccer
  • Basketball
  • Gymnastics
  • Baseball
  • Football
  • Running
  • Lacrosse
  • Tennis
  • Softball
  • Wrestling
  • Track
  • Volleyball
  • Cheerleading
  • Swimming
  • Tumbling
  • Ballet
  • Biking
  • Flag Football
  • Hockey
  • Farming Work
  • Brazilian Jitjitzu
  • PE
  • Acrobatics
  • Rugby
  • Taekwondo
  • Dance
  • Tap Dancing
  • Golf
  • Ultimate Frisbee
  • Skating

Available Treatment Options for Sever's Disease

Comparing Acute Vs Chronic Treatment Options

Acute Sever's Disease Treatment

When dealing with the stages or less severe cases of Severs Disease it is usually effective to opt for conservative treatment methods.

This primarily involves allowing the child to rest and reducing their involvement in activities that strain the heel. Applying ice to the area can help alleviate inflammation and pain and, over the counter pain relievers can be used as directed to manage any discomfort. Gentle stretching exercises targeting the calf muscles and Achilles tendon can aid in relieving tension and promoting recovery.

In some cases a Pediatric Brace may be recommended to provide additional support during the healing process. The pediatric night brace is effective as supportive treatment for Acute flares. Although The Mikki Device can be utilized to treat Acute Sever’s, the use of custom orthotics is generally not required. However it is always advisable to consult with a healthcare pediatric podiatrist who can tailor the treatment approach according to your childs specific condition and requirements.

Chronic Sever's Disease Treatment

The Mikki Device Sever’s Solution Kit

The lack of treatment available was the driving force behind the development of the Mikki Device. The Mikki Device is an at-home treatment for Chronic Sever’s disease and doesn’t require a doctor’s appointment or a prescription. 

The solution kit for chronic cases is the pediatric night brace and Mikki Device orthotics.

The Mikki Device showcases a 95% success rate in alleviating even the most persistent cases within 8 weeks or less for children between the ages of 7 to 16. 

The custom orthotics can be comfortably worn in your child’s regular footwear or sports cleats, while the pediatric night splint is delivered according to your child’s shoe size.

The Only Sever's Disease At-Home Treatment

The Mikki Device is the solution you need. As the only at-home treatment for Sever's Disease, it offers the expertise of a pediatric podiatrist right in the comfort of your home.

In Closing

In conclusion it is important to be aware that children who participate in sports may face a risk of foot injuries, such as heel pain commonly associated with conditions like Sever’s Disease.

Detecting these conditions early and managing them promptly is crucial to minimize discomfort and prevent any disruption  in a child’s lifestyle. It is reassuring to know that effective treatment is available.

One notable option, the Mikki Device, specifically designed for at home treatment of Severs Disease. As a caregiver your role, in recognizing symptoms, seeking treatment and creating a supportive environment for your child’s recovery can greatly contribute to their ability to enjoy sports without pain. 

After all, a child’s laughter and joy on the playground are irreplaceable sounds of health and happiness.