Newsletter – Spring 2008

Parents! Don’t Ignore Child’s Heel Pain
Preventing Children’s Heel Pain
Old Ankle Injury Acting Up this Spring?
Broken Toe ‘Myths’


Parents! Don’t Ignore Child’s Heel Pain

Now that children’s activities are moving outdoors for spring and summer, many parents will find their young ones, especially those involved in athletic pursuits, complaining of painful heels.

Children’s heel pain is different from that experienced by adults. While adults may experience pain immediately upon arising in the morning, which goes away after walking and stretching, children’s heel pain usually becomes worse with increased activity.

Heel pain is a symptom, not a disease. In other words, heel pain is a warning sign that a child has a condition that deserves attention. Because there are a number of possible causes for a child’s heel pain, it is important that parents have the child examined in our office for a definitive diagnosis and treatment.

Heel pain is so common in children because of the very nature of their growing feet. In children, the heel bone is not fully developed until age 14 or older. Until then, new bone is forming at the growth plate, a weak area located at the back of the heel. As children participate in active sports, especially if they are wearing cleated shoes or running on hard surfaces, injury can occur to this vulnerable area.

Common Causes

The most common cause of children’s heel pain is inflammation of the heel’s growth plate due to muscle strain and repetitive stress. Heel pain can also be due to bursitis, tendonitis, or fractures. When the child is brought to our office we will ask about activities they are involved in, examine the foot and leg, and may take x-rays.

Many children today are participating in sports activities almost every day of the week, with little time for their muscles, tendons, and bones to rest and recover from the pounding they receive. Parents are advised to watch their children carefully and not allow them to continue playing when pain is present.

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Preventing Children’s Heel Pain

The chances of a child developing heel pain can be reduced by following these recommendations:

  • Overweight children are more prone to stress injuries of the foot. Help your child to maintain an appropriate weight.
  • Don’t allow your child to wear “hand me down” or worn out shoes.
  • Avoid, or limit, the child’s wearing of cleated athletic shoes.
  • Avoid activity that exceeds the child’s physical abilities.
  • Choose well-constructed, supportive shoes that are appropriate for the child’s activity.

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Old Ankle Injury Acting Up this Spring?

After a winter of relative inactivity, most people are anxious to enjoy outdoor activities once good weather arrives. But many will find that months of watching sports from the couch have left the muscles, tendons and ligaments of their ankles in less-thanprime condition for participating in active pursuits. Especially vulnerable is anyone who has had an ankle sprain that may not have been fully rehabilitated in the past.

A sprain that happened years ago can leave residual weakness that isn’t noticed in normal daily activity, but subjecting the ankle to rigorous physical activity can further damage improperly healed ligaments, and cause persistent pain and swelling. If you’re embarking on a fitness or athletic program this spring, call our office for an appointment to have that old ankle injury checked out before becoming active again. Pain in the ankle area is never normal…even when you’re trying to get back in shape!

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Broken Toe ‘Myths’

Myth #1: “A doctor can’t do anything for a broken toe.”

Although it isn’t true, unfortunately many people believe this myth, and never get proper treatment for these injuries. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop. For example:

  • The bones may become deformed, thereby limiting the ability to move the foot or causing difficulty in fitting shoes.
  • If there is a fracture in a joint (the juncture where two bones meet), arthritis may develop. Arthritis may also be a result of angular deformities that develop when a displaced fracture is severe or hasn’t been properly corrected.
  • An untreated fracture can cause chronic pain and long-term dysfunction.
  • A fracture that does not heal can lead to the need for surgery.

Myth #2: “If you can walk on it, it isn’t broken.”

Many people believe this myth, and will continue to walk after a bone in their foot is fractured…sometimes resulting in even greater damage. Symptoms of a fracture include:

  • Pain at the time the fracture occurs and perhaps for a few hours later, but often the pain goes away after several hours.
  • Misshapen appearance of the toe.
  • Bruising and swelling the next day. In addition to fractures that are caused by trauma to the foot, some people (especially those who participate in athletics or who suffer from osteoporosis) may get a stress fracture in their foot. Although one can walk on a foot that has a stress fracture, these tiny, hairline breaks should not be ignored, because they will come back unless properly treated.

You may have a stress fracture if you notice:

  • Pain with or after normal activity
  • Pain that goes away when resting and then returns when standing or during activity
  • Pain at the site of the fracture when touched
  • Swelling, but no bruising.

The bottom line is, fractures of the foot require proper treatment. Even if your fracture has been treated in an emergency room, follow-up with our office is advised to avoid improper healing and possible long-term consequences.

This information was developed by the American College of Foot and Ankle Surgeons.

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