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Heel Pain In Children

ASK THE EXPERT Heel Pain In Children

By Dr. Carlo A. Messina

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Does 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

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 ▸ 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

⊲ 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.

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Surgical Oncology & Pancreatic Surgical Oncology

Specializing in Cancer of the Pancreas, Liver, GI Tract, Sarcoma, Adrenal, Thyroid, Parathyroid, and Melanoma. Laparoscopic and Image Guided Cancer Surgery, IRE/NanoKnife for NonResectable Pancreatic and Liver Cancer.

Dr. Robert Donoway who is a board certified Fellowship-trained Surgical Oncologist, received his MD and Surgical training at the University of Pennsylvania. He completed his fellowship in Surgical Oncology at Sloan-Kettering where he was the General Motors Cancer Research Fellow. He has taught on the faculty at Penn, Sloan-Kettering, University of Miami and Nova Southeastern. Dr. Donoway is the former Medical Director of the Memorial Cancer Institute and Chairman of the Cancer Committee for the Memorial Healthcare System as well as Chief of Surgery and Surgical Oncology at Memorial Regional in Hollywood, South Florida. Dr. Donoway served on the Board of the American Cancer Society & Gildas Club. He has also served as past President of the American Cancer Society Broward County Chapter. Dr. Donoway is active in the Society of Surgical Oncology and the American Pancreatic Association. His accomplishments include being the first Surgeon in Florida to perform Radio Frequency Ablation as well as Laparoscopic Liver Resection. Dr. Donoway is a recent recipient of the South Florida Health Award for the use of Micro-Endoscopy for the detection of early stage Breast Cancer. Dr. Donoway is the Medical Director of the Institute of Breast Cancer Prevention and has been repeatedly named to “TOP DOCTORS IN AMERICA” by Castle Connolly. Dr. Donoway is the ONLY surgeon in Florida performing specialized Pancreatic and Liver ablation therapy for non-resectable tumors. Dr. Donoway is the Former Chair of the Aventura Cancer Committee at Aventura Hospital and Medical Center. Dr. Donoway has privileges and operates at Aventura Hospital, Memorial Regional, Memorial South and Memorial West.

Robert B. Donoway, M.D., F.A.C.S., F.S.S.O.

Diplomate American Board of Surgery Diplomate, Society of Surgical Oncology Former Medical Director & Memorial Cancer Center Medical Director, Atlas Oncology: Institute for Pancreatic Cancer IRE/NanoKnife Ablation

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