With fall sports in full swing, it is time to be on the lookout for heel and arch pain. One of the most common areas where we see the pain this time of year is the back of the heel, where the Achilles tendon attaches to the heel bone. This tends to bother both children and adults, but for very different reasons. Fortunately, at Kansas City Foot and Ankle, our experts are well equipped to deal with both issues. Heel pain is one of the most common problems we see at Kansas City Foot and Ankle and we are experts in this field.
In children, pain to the back of the heel associated with the activity is usually known as calcaneal apophysitis or “Sever’s Disease.” This is not actually a “disease” per se but is more associated with normal growth in active children. When children grow, their bones develop “growth centers” where the bones grow from and become longer. In kids, one of these areas is at the back of the heel bone where the Achilles tendon attaches to the heel bone. Usually, this is not a problem but in active children, the growth center can get inflamed from activity and from tightness in the Achilles tendon. Usually, the Achilles tendon is too tight and pulls on the heel bone at the growth center and over time this causes pain and inflammation for the child. This is usually worse with activities or in the mornings and is generally improved with rest, ice, and stretching to reduce pull on the Achilles tendon. Custom made orthotic inserts and heel lifts are commonly used to treat this problem. Physical therapy is also a great treatment option for Sever’s Disease and can be prescribed by our physicians if needed.
In adults, pain to the back of the heel happens generally because of chronic tightness to the Achilles tendon that often results in small tears at the attachment of the Achilles tendon. Over time a heel spur can develop off the back of the heel bone from the chronic pull of the Achilles tendon on the heel bone. These heel spurs are often not the cause of the pain but can become so large they can make wearing shoes difficult if the spur rubs on the back of the shoe. This problem is most often known as chronic Achilles tendinopathy with an “exostosis” (heel spur) on the back of the heel. Treatment for Achilles tendinopathy generally involves stretching, icing, physical therapy, custom orthotics, and occasionally shoe modifications to take pressure off the back of the heel. Occasionally, adults will have “acute” Achilles tendonitis which generally happens from an injury. The treatment for the acute form of Achilles tendonitis usually involves rest and immobilization with anti-inflammatory medications and then after the pain is improved the treatment focuses more on rehabilitation. We also have more advanced treatment options like Extra-Corporeal Shockwave Therapy or Amniofix injections, which are both focused on the long-term healing of the tendon if needed. Surgery is always a last resort option for this problem.
At Kansas City Foot and Ankle, we have experienced physicians and surgeons to take care of both of these common causes of foot and ankle related pain. Dr. Daniel Miller, Dr. Stephanie Jameson, Dr. Dusty Christensen, Dr. Ross Bartley, Dr. Dan Hanon, and Dr. Mark Green are all experts in heel pain. If you or your child are having heel pain, call today to set up an appointment and start your recovery today. Foot pain is never normal! Call 816-943-1111 to set up an appointment with our experts.