Why does my son have pain in both his heels?

Q: My son aged 12yr is suffering from pain in both heels which developed after he started playing cricket. The X-ray shows hyperdensity of the calcaneum [post-ossifing bone]. What is the cause for pain; its treatment and long term complication?

A:Your son seems to be having Sever's disease of both sides. This is a type of traction apophysitis affecting the insertion of one of the largest and important tendons, tendo-achilles over the heel bone calcaneum. This problem affects susceptible children of your sons age group, who are very active. Treatment would entail cessation of cricket to start with, unfortunately. He would have to refrain from playing any contact sports, any PT in school or any excessive running and jumping, for at least 6 weeks to a period of 3 months. He would require re-assessment at regular intervals to ensure the response to treatment. The only sport which he can indulge in is swimming. This problem is typical of a growing child and dissappears once the child attains skeletal maturity or completes growth.