A common cause of heel and arch pain in children is a condition called plantar fasciitis.
Plantar fasciitis is an inflammation of the soft tissue that runs along the arch of the foot, from the heel to the toes. The plantar fascia helps to stabilize and support the arch during walking and it is often injured when children are involved in sports or high impact activities.
What causes Plantar Fasciitis in children?
Heel and arch pain is most commonly the result of faulty foot biomechanics and abnormal foot posture. Abnormal foot function loads too much stress on the heel bone and the soft tissues that attach to it. This increased stress causes inflammation and pain under the heel and across the arch.
There are several factors that may contribute to the development of plantar fasciitis in children, including:
- Abnormal foot posture – flat feet, or pronated feet that roll in too much, overload the plantar fascia causing inflammation and pain
- Unsupportive footwear – overly flexible school shoes or sports shoes place increased load on the plantar fascia
- Joint hypermobility – children with overly-flexible joints are more prone to arch strain
- Calf muscle tightness
- Increase in sports training routines
- Childhood obesity – carrying excessive weight on growing feet can result in injury to the soft tissues that support the feet
What are the symptoms of Plantar Fasciitis?
The most common symptoms of plantar fasciitis include:
- Pain under the heel, worse with the first few steps after resting or sitting
- Increasing pain at the end of the school day
- Pain under the heel and across the arch with running activities
- Pain walking on hard or unforgiving surfaces (eg: bathroom floor, cement)
How is Plantar Fasciitis diagnosed?
Your podiatrist will take a comprehensive medical history and complete a physical examination and visual gait analysis. The assessment will include:
- Pain provocation tests
- Foot posture assessment
- Joint flexibility tests (or range of motion)
- Foot and leg muscle strength testing
- Gait analysis and biomechanical assessment – to look for any abnormalities in the way the feet and legs move during gait
- Footwear assessment.
Treatment for plantar fasciitis in children is most effective when treated early and may include a combination of the following:
- Rest – from high impact activities until your child is able to walk comfortably
- Strapping – strapping the foot with sports tape can help to reduce strain on the plantar fascia and provide some pain relief
- Footwear – changing to a supportive, stable school shoe will help to support and stabilize the feet
- Foot Orthotics – to improve your child’s foot posture and reduce the load on the plantar fascia
- Home exercise program – calf and fascia stretches and foot muscle strengthening exercises
- Ice massage – to reduce local inflammation
- Massage therapy
What should I do if my child has Plantar Fasciitis?
If your child is experiencing heel pain, or you are concerned about their gait or foot posture, don’t hesitate to consult with our experienced paediatric podiatrists for a comprehensive walking assessment and professional advice.