Often children will not tell parents of foot pain, simply because they don’t know anything is wrong with it. Childhood foot problems are more common than most people think. If you have observed your child walking on their toes, limping, or complaining of heel pain and not wanting to participate in athletic activities, it is possible your child may have some sort of heel discomfort. In most cases there is nothing to worry about. In children, their feet are growing and ever changing, and in the foot especially the heel bone also known as the calcaneus, it has not fully developed. Until fully developed at or around the age of 14, new bone will continue to form around the growth plate or apophysis, which is considered a weak area on the back of the heel. Too much stress in this area of the body is the most common cause of pediatric heel pain. These are five signs every parent should look out for childhood foot problems. 1. Your Kids Can’t Keep Up with Their Peers If children lag behind in sports or backyard play, it may be because their feet or legs are tired. Fatigue is common when children have flat feet. The muscles in the feet and legs tire easily because the feet are not functioning as well as they should. 2. Children Voluntarily Withdraw from Activities they Usually Enjoy If they are reluctant to participate, it may be due to heel pain — a problem often seen in children between the ages of 8 and 14. Repetitive stress from sports may cause muscle strain and inflammation of the growth plate, a weak area at the back of a child’s heel. 3. They Don’t Want to Show You Their Feet Children may feel pain or notice a change in the appearance of their feet or nails but don’t tell their parents because they fear a trip to the doctor’s office. Surgeons encourage parents to make a habit of inspecting their child’s feet starting at a young age. Look for any changes such as calluses, growths, skin discoloration, or redness and swelling around the toenails. 4. Your Child Often Trips and Falls Repeated clumsiness may be a sign of in-toeing, balance problems or neuromuscular conditions. 5. The Child Complains of Pain It is never normal for a child to have foot pain. Injuries may seem minor, but if pain or swelling last more than a few days, have your child’s foot examined. There are several causes of foot pain in children. Calcaneal apophysitis also known as Sever’s disease, is the most common cause of heel pain in children. It is an inflammation of the heel’s growth plate due to muscle stretch, strain, and repetitive stress, especially in those who are active or overweight. This condition is usually associated with pain and tenderness in the back and bottom of the heel when walking, and the heel is painful when pressed or touched. It can occur in one or both feet. Tendo- Achilles bursitis is also a condition that causes heel pain. This pain is due to inflammation of the fluid-filled sac or bursa located between the Achilles tendon and the heel bone itself. Tendon-Achilles bursitis can result from injuries to the heel, and certain diseases such as juvenile rheumatoid arthritis, or wearing inadequate shoe gear. Highly active children are more at risk for overuse injuries. Overuse syndromes can also cause heel discomfort in children. Because the heel’s growth plate is sensitive to repeated running and pounding on hard surfaces, pediatric heel pain often reflects overuse. Children and adolescents involved in impact sports like track, football, basketball, or soccer are especially at risk. One common overuse syndrome is plantar fascitis, which is an inflammation of the fibrous band of tissue than runs along the bottom of the foot from the heel all the way to the toes. Fractures can also cause heel pain in children and is caused by a break in the adolescents who engage in athletics, and is especially noticed when the intensity of training suddenly increases. Acute fractures can also result in heel pain and usually occurs in children under the age of 10 and is direct from a fall or jump from more than 2 or 3 feet. remember heel pain is a condition not a disease and if your child has heel pain don’t hesitate to make an appointment with your local podiatrist here at the Atlantic Foot & Ankle Specialists.