Pain in the rearfoot of kids is not common, however when it does happen, the most frequent reason is a condition called Severs disease. It is not really a “disease”, however it is the term which has regrettably widely used. It is actually properly known as calcaneal apophysitis. It is a issue with the growing area at the rear of the heel bone. As it is a problem, of the growing bone, the condition is self-limiting and will no longer be a concern once the growth of that bone has completed. It is more common around the age groups of 10-12 years.
The common characteristic of Severs disease are usually discomfort on activity and discomfort on squeezing the sides of the back part of the heel. At first the discomfort is relatively minor and will not impact activity much, but later it will become more severe and impacts activities levels and may also lead to limping. The precise reason for it is not clear, but it is obviously an overuse type problem because it is more common in those who play more sport and more frequent in children who have a higher BMI. Kids with tight calf muscles might be at a increased possibility for the development of Severs disease.
Commonly, the management of Severs disease is load management. The child is encouraged to keep active, but just reduce exercise levels to a level that can be tolerated and not too painful. A cushioning heel pad in the footwear may be useful to cushion it. Ice following activity may also be useful to help the pain. If the leg muscles are tight, then a stretches needs to be started. Sometimes foot orthotics can help when the arch of the foot is overpronated. On rare occasions a splint can be used, and all sport stopped until it gets better. By the mid-teens the growing plate that this occurs at combines with the rest of the heel bone, so this ceases to be an issue at those ages.