Plantar fasciitis living in children

Overview

Plantar fasciitis is a condition that causes pain in the heel and bottom of the foot. The plantar fascia is a thick band of tissue that runs from the heel bone to the toes. When this tissue becomes irritated or inflamed, it hurts. In children, this problem is less common than in adults but can happen, especially if they are very active in sports or running.

Plantar fasciitis is more common in adults, but it can occur in children, especially those who are very active in sports like running, jumping, or dancing. It is not rare, but it is not the most common cause of foot pain in children.

It affects children of all ages, but most often those between 8 and 14 years old who do a lot of running or jumping activities. It can also affect children who have flat feet or tight calf muscles.

Symptoms

Common symptoms

• Pain under the heel, especially when taking the first steps in the morning
• Pain that gets better after walking a little but may come back after sitting for a long time
• Tenderness or soreness when pressing on the bottom of the heel

Symptoms in children

• Pain that makes the child limp or avoid putting weight on the heel
• Complaints of heel pain after sports or physical play
• Tightness in the calf or Achilles tendon
• Favoring one foot when standing or walking

Symptoms in older adults

• More constant heel pain that can last all day
• Stiffness in the foot in the morning that lasts longer than 10 minutes
• Pain that gets worse with prolonged standing or walking

Causes

Main causes

• Repeated strain on the plantar fascia from running, jumping, or other high-impact activities
• Tight calf muscles that pull on the heel bone

Risk factors

• Being very active in sports that involve running and jumping
• Having flat feet or high arches
• Wearing shoes that do not provide enough support, especially for sports
• Sudden increase in activity level or intensity of training
• Being overweight, which puts extra pressure on the feet

When to see a doctor

See a doctor urgently if:

• If the child has severe pain after an injury, like a fall or twist
• If the foot looks red, swollen, or feels hot to the touch

Book a routine appointment if:

• If heel pain lasts more than two weeks despite rest and home care
• If the child limps or avoids activities they used to enjoy
• If the pain wakes the child up at night

Diagnosis

A doctor will ask about the child's symptoms, activity level, and medical history. They will look at the foot, press on the heel, and watch the child walk. Usually, no special tests are needed.

Tests that may be done

• Sometimes the doctor may order an X-ray to rule out other causes of heel pain, like a stress fracture or bone cyst.

What to expect at your appointment

The doctor will explain what plantar fasciitis is and give advice on how to manage it at home. They may also suggest seeing a physical therapist or a podiatrist (foot specialist) if the pain continues.

Treatment

Treatment focuses on reducing pain and inflammation, and then slowly returning to activities. Most children get better without surgery. The doctor will guide you on the best approach.

Self-care at home

• Rest from activities that cause pain, like running or jumping for a few days to weeks.
• Ice the bottom of the heel for 10 to 15 minutes, 3 to 4 times a day. Place a thin cloth between the ice and skin.
• Do gentle stretching exercises for the calf muscles and Achilles tendon. Hold each stretch for 30 seconds and repeat 3 times.
• Wear supportive shoes, not flat or worn-out shoes. Avoid going barefoot on hard surfaces.
• Massage the arch of the foot gently with a tennis ball or frozen water bottle.

Medical treatments

A doctor may recommend over-the-counter pain relievers like paracetamol or ibuprofen to reduce pain (always follow dosing instructions for children). They might also suggest using a heel cup or arch support in the shoes. Physical therapy can help with stretching and strengthening exercises. In some cases, a podiatrist may use taping or recommend custom orthotics (special shoe inserts).

When is surgery considered?

Surgery is rarely needed for children with plantar fasciitis. It is only considered if the pain does not go away after many months of other treatments and is affecting the child's daily life.

Living with this condition

Help your child take breaks from activities that hurt. Encourage them to stretch before and after sports. Supportive shoes and not going barefoot can make a big difference. The pain may come and go, so be patient and consistent with home care.

Lifestyle tips

• Encourage other low-impact activities like swimming, biking, or yoga while the foot heals.
• Make sure your child has good-quality shoes for sports and daily wear.
• Teach your child to stretch their calves and feet regularly, especially before sports.

Diet and exercise

A balanced diet helps keep a healthy weight, which reduces stress on the feet. For exercise, choose activities that do not pound the heel, like biking or swimming, until the pain is gone.

Mental health and emotional wellbeing

Heel pain can be frustrating for a child, especially if it keeps them from playing sports or hanging out with friends. They may feel left out, sad, or worried. It helps to talk with them and find fun, pain-free activities they can do. Reassure them that the pain will likely get better with time and care.

Prevention

You cannot always prevent plantar fasciitis, but you can lower the risk. Have your child wear supportive shoes, increase activity gradually, and stretch their calves and feet regularly.

Vaccines

There is no vaccine for plantar fasciitis.

Screening programmes

There is no routine screening test, but if your child has foot pain, early checkup helps.

Complications

If left untreated

• Chronic (long-lasting) heel pain that makes walking and playing hard
• Changes in how the child walks, which can lead to knee, hip, or back pain
• Other foot problems like Achilles tendonitis or arch pain

Long-term outlook

With proper care, almost all children with plantar fasciitis recover fully and can return to sports and play. It may take several weeks to months, but the outlook is very good. Surgery is almost never needed.

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