My six-year-old daughter has been complaining of pains in her heels which hurt when she walks. What could be causing this and how can the pain be eased?
Conventional remedy
A condition known as Plantar Fasciitis can cause a pain in the heel area. It typically occurs in adults over the age of 40 or in those whose job involves walking or standing for long periods of time. It can, however, occur in active children who are involved in sporting activities that include running or jumping. It is caused by inflammation of the point where the ligament, plantar fascia, attaches to the main heel bone, the calcaneus.
Symptoms include pain in the heel that is often worse after rest periods. Climbing stairs can also bring on the pain. Often the heel is tender to touch and an X-ray may reveal a small spur on the bone. The pain usually resolves within a year. In the meantime, using a small pad under the heel can help. It should be thick enough to raise the heel by about one centimetre and have either a hole cut out over the painful area or be U-shaped to prevent the affected area coming in contact with the sole of the shoe.
Special strapping using non-stretch tape can also be of use if the problem is severe. Rest from running, jumping and long walks will help the problem resolve. If the problem continues you should take your child to your family doctor for a full examination. - Dr Muiris Houston
Alternative remedy
Firstly we need to rule out a few of the obvious causes. Shoes that are too tight at the toe, too tight across the midfoot or around the heel can cause this discomfort. Other shoe problems include heels that are too high or soles that are too rigid or flexible. A new activity such as ballet or Irish dancing can cause new abnormal strain through the foot and heel. Heel pain is a common extra complaint of those suffering from osteochondrosis of the knees, though this condition usually starts in the early teens.
We see this problem fairly regularly at the practice. As osteopaths, we are trained to evaluate thoroughly the child's postural mechanics; the way they stand, walk and sit. It is important to work out where the child's centre of gravity is; how the spine, hips, knees and feet function as a unit; and if there are any areas of dysfunction. A small problem in any of these areas can upset the subtle balance of the ankle and foot mechanics. It is important to look at a whole multitude of factors when evaluating these subtle problems in children.
More and more osteopaths are being trained in the techniques of cranial osteopathy. These gentle techniques are suited to treating young children and babies and can help with a wide variety of conditions including colic and sleeplessness, glue ear, asthma, learning and behavioural difficulties and a wide variety of muscular-skeletal problems. - Ian Wright
Ian Wright is a registered osteopath based in Clonmel, Co Tipperary. Registered osteopaths can be contacted via the Irish Association of Osteopaths on: 01-2695281
The advice in this column is not intended as a substitute for advice received directly from a medical doctor and/or alternative practitioner. Individuals should receive a thorough diagnosis of complaints before embarking on treatment options.