ASK THE EXPERT
Heel Pain In Children By Dr. Carlo A. Messina
D
oes your son or daughter complain of heel pain daily, especially during or after activity? Do they remember any traumatic event or did the pain just occur? If this sounds like your child, there is a high probability that they have Calcaneal Apophysitis (or Sever’s Disease). This is actually a condition and not a disease. This occurs when the growth plate (apophysis) located at the bottom and back of the heel (the portion of the bone that allows growth) becomes painfully inflamed. Although plantar fasciitis (inflammation of the ligament that supports the arch) is the most common cause of heel pain in adults, it is extremely uncommon in children. Cause: ▸ Growth plate inflammation on the back and the bottom of the heel ▸ Over-activity in children commonly between the ages of 8 and 14 ▸ Tight muscles in the lower extremity, especially
the calf muscle ▸ Flatfeet ▸ Poor shoe gear or walking barefoot ▸ Growth spurts
Symptoms:
▸ Discomfort in the heel bone at the end of activity ▸ Occasionally painful to the Achilles and ankle ▸ Stiffness in the foot in the morning and pain with walking or running ▸ Pain alleviated by rest and a decrease in activity ▸ Pain is usually present during or after a child is done with the activity, sits for a period of time, and then tries to get up and walk
Signs:
▸ Tenderness to the back and bottom of the heel with touch or grasping the heel ▸ Walking on the ball of the foot to avoid touching the heel to the ground ▸ Discoloration and swelling are almost never seen in the heel ▸ Limping at the end of an activity that may persist as the condition worsens
▸ Custom molded orthotics to support the foot and help restore proper alignment ▸ Occasional immobilization in a boot or cast to completely rest the heel and allow healing ▸ Physical therapy to improve flexibility and diminish inflammation of the growth plate n Carlo A. Messina, DPM, is a Board Certified Reconstructive Foot and Ankle Surgeon, Diplomate American Board of Foot and Ankle Surgery. He is a Foot and Ankle Surgeon with the Foot, Ankle and Leg Specialists of South Florida and specializes in treating infants, children, teens and adults. His partners are Dr. Robert Sheinberg, Dr. Al DeSimone, Dr. Fernando Moya, Dr. Alexander Bertot, Dr. David Shenassa, Dr. Michael Cohen, Dr. Franz Jones and Dr. John Goodner. The South Florida Institute of Sports Medicine in Weston is located at 1600 Town Center Blvd., Suite C, (954) 389-5900 and in Pembroke Pines at 17842 NW 2nd Street, (954) 430-9901. The practice website is www.SOUTHFLORIDASPORTSMEDICINE.com.
Treatment:
▸ Modification of activity and avoiding going barefoot ▸ Rest and ice ▸ Stretching exercises ▸ Proper shoe gear and heel lifts to decrease tension on the heel ▸ Night splinting to stretch the tight calf muscle and arch ligament ▸ Taping the foot to decrease the pulling of the plantar fascia on the heel bone
ACCEPTING: MEDICARE •BLUE CROSS BLUE SHIELD • UHC • CIGNA • AETNA • AV MED • AMBETTER • TRICARE WORKERS COMP • ACCIDENTS/LOPS • SIMPLY • STAYWELL • SUNSHINE • BETTER HEALTH • OSCAR • MEMORIAL PHO
South Florida Institute of Sports Medicine
FOOT, ANKLE, & LEG SPECIALISTS OF SOUTH FLORIDA
OPEN DAILY FOR SAME DAY APPOINTMENTS & TELEMEDICINE DURING THE COVID19 CRISIS
PEDIATRICS
• Flat feet • High Arches • Fractures • Growing Pains • Warts
• Toe Walkers • In Toe • Out Toe • Limping • Ingrown Nail
FRACTURES Why go to an Emergency Room? All Foot, Ankle, and Leg Fractures in Children and Adults! FOOT AND ANKLE ARTHRITIS Total Joint Replacement, Ankle Replacement, Arthroscopy, Fusions, Joint Realignment
CARTILAGE INJURIES Microfractures, Cartilage Transplants, Osteochondral Grafting RECONSTRUCTIVE FOOT, ANKLE AND LEG SURGERY Flat Foot, Bunions, Hammertoes, Ligament Repair, Achilles Tendon Tears, Arthritis Surgery SPORTS MEDICINE Tendon and Ligament injuries, Heel Pain, Shockwave Therapy, PRP & Stem Cell Injections, Arthroscopy and Tendoscopy, Shin Splints, Compartment Syndrome
SERVING OUR PATIENTS FOR OVER 30 YEARS Dr. Warren Windram, D.P.M.
Board Qualified FOOT, ANKLE, & LEG SPECIALIST
Dr. John Goodner, D.P.M.
Board Qualified FOOT, ANKLE, & LEG SPECIALIST
Dr. Robert Sheinberg, D.P.M. - In Loving Memory -
Dr. Carlo Messina, D.P.M.
Board Certified FOOT, ANKLE, & LEG SPECIALIST
WESTON
PEMBROKE PINES
954-389-5900
954-430-9901
1600 Town Center Blvd.
17842 NW 2nd St.
Dr. Michael Cohen, D.P.M.
Board Certified FOOT, ANKLE, & LEG SPECIALIST
PLANTATION
220 S.W. 84th Ave., #102
954-720-1530 SATURDAY HOURS
Make Your Appointment Online at www.SouthFloridaSportsMedicine.com
FOOT, ANKLE & LEG QUESTIONS? EMAIL THE DOCTOR! DrJohnGoodner@gmail.com (Don’t Send Protected Health Information)
IMEs • Personal Injury • Worker’s Compensation Most HMOs/PPOs • All Foot Ankle & Leg Emergencies Same Day Appointments • Saturday Appointments Early Morning & Evening Appointments
SELF PAY RATES (Procedure cost is in addition to office visit.) New Patient . . . . . . . . . . . . . . $200 Surgery Consult . . . . . . . . . . . $200 Injections . . . . . . . . . .$75 per shot Casts . . . . . . . . . . . . . . . . . . . . .$175 Follow Up Visit . . . . . . . . $50-$100 Orthotics . . . . . . . . . . . . . . . . . $350 Ingrown Nail . . . . . . . . . . . . . .$125 X-Rays . . . . . . . . . . . . $50 per area PRP . . . . . . . . . . . . . . . . . . . . .$600 Shockwave (3 sessions) . . . . $500 Laceration Repair . . . . . . . . . $250 Wound Care . . . . . . . . . . .$75-$125 (FOR CHRONIC HEEL PAIN & TENDONITIS)
SPORTS MEDICINE ASSOCIATES (Self Pay Rates Do Not Apply To This Practice Below)
Dr. Al DeSimone, M.D. Board Certified SHOULDER & KNEE SPECIALIST
Dr. Fernando Moya, M.D. Board Certified SHOULDER & KNEE SPECIALIST
Dr. David Shenassa, M.D. Board Qualified HAND & WRIST SURGEON
Dr. Alexander Bertot, M.D. Board Certified SPORTS MEDICINE SPECIALIST
Dr. Franz Jones, D.O. Board Certified SPINE SPECIALIST
Our City Weston / March 2021 / OurCityMedia.com / 61
