Heel pain in children
The most common presentation of heel pain in children is very different to an adult heel condition. The heel bone has a number of growth plate centres and these can be affected through high impact activity and tight muscles associated with rapid growth. The condition is called ‘Severs disease’ and is most common between the ages of 9 and 14. The pain is related to activity and can be so severe to cause limping. There has been an association found between the tight muscles of the leg, rapid growth and poor foot posture with this type of boney ‘inflammation’. Podiatrists are the best practitioners to diagnose this problem and its related causative gait, a podiatrist will also advise a course of treatment including appropriate shoe insoles and exercises.
The thickness of skin on our feet is different to skin on other parts of our body. The heel area in particular is very strong and thick, unfortunately this can also mean it has low elasticity and can crack and fissure with high pressures and a drying environment. Some people will be more prone to heel cracks than others because of their skin type, or diabetes. Other factors such as weight, sling back or open shoes/ bare feet and lack of moisturiser application in dry weather are factors that you can do something about. A podiatrist will help remove the callused skin and advise on appropriate footwear and foot care. The cracks can often disappear after a few regular treatments and with care at home the problem can be easily addressed. If left unattended the cracks can be a source of entry for infection, which can affect the whole leg or are simply painful and unsightly.
Morning heel pain
There are a number of different possible causes of heel pain from direct injury, to inflammation of the connective tissues, to fracture of the heel bone.
Intense pain felt on rising in the morning, in the middle of the heel is the most common scenario. After walking for a little while, the pain eases, until the end of the day when the pain returns. This is typical of ‘plantar fasciitis’, a swelling of the connective tissue that holds the arch of the foot together. Treatment sought early will give the best results. After a period of 3-6 months the problem becomes more complicated and involves other structures and is more difficult to resolve. Podiatrists are trained to diagnose foot and heel pains. There are a number of short -term treatments that are successful at reducing the inflammation. Long term a podiatrist will look at gait, posture, footwear and activity to find the cause of the strain.