Q: My 13 year old son (soccer player) has been complaining of heel pain. I do not recall an episode or injury- what could it be?

A: Children can develop true “growing pains” in their heels, generally around 10-13 years of age. The main portion of the heel bone, or calcaneus, is present at birth. However, at the very back end of this bone, a second portion of the heel bone develops at this age. It eventually joins up with the main part of the heel bone, but during this period of several years, it is susceptible to stress from a “tug-of-war” between the Achilles tendon and the ligaments on the bottom of the foot, especially in children who are athletic. Icing, activity modification, anti-inflammatory medication, and a short period of non-weight bearing casting is effective in treating this condition.