Injury prevention for active children

Sports  •  Sat 2 Nov 2019

Has your child had a niggling pain in their arch or heel throughout the winter sporting season?

Here's what they can be doing during the summer to get them better prepared for the next season.

Heel and arch pain

As a Podiatrist and U15 Football coach, I am regularly in contact with young, sporty children with heel or arch pain.

All too often, I find these children are unsure about what they can do during the off-season to better prepare themselves for the season ahead.

Many of the children who I see in the clinic with pain commonly have tight and weakened calf muscles.

I often find myself prescribing a similar initial exercise program to help strengthen the calf muscles as part of my management plan for these children.

Why are the calf muscles important to heel and arch pain?

I like to think of the calf muscles as the drivers of the foot and any weakness or tightness in the calves means that the heel and arch take more strain to compensate. 

The calf muscle complex is comprised of two main muscles:

1. Gastrocnemius: mostly “fast-twitch” fibres designed for explosive jumping
2. Soleus: mostly “slow-twitch” fibres designed for power and endurance

These two muscles work at different times when you walk or run therefore specific exercises to target each part are vitally important to any calf muscle strengthening program.

Exercise 1: Single leg calf raise with knee straight

This exercise targets the Gastrocnemius muscle and is one of the exercises I most commonly prescribed but is often done incorrectly.

Some important points to remember when your child is performing this exercise are:

• This exercise should be done SLOWLY! Your child should take 2 seconds to go up, have a 2-second hold at the top and take 2 seconds to go down
• Your child should rise straight up during the calf raise. Tell your child to imagine they have a string pulling them straight up and not to lean forward
• Their knee should be kept straight at all times, don't let them recruit other larger muscles to help with the exercise

I recommend my clients to aim for is 3 sets of 12-15 repetitions however this depends on your child's muscle strength to start with.

Exercise 2: Single leg calf raise with knee bent

The next exercise is similar to the first however it targets the Soleus muscle.

This exercise is tricky to do at first however the correct technique is important.

Some important points for your child to remember when performing this exercise are:

• Your child should slightly bend the knee of their standing leg and keep it bent throughout the exercise, don't allow them to straighten their knee as they rise up
• Your child should perform this exercise slowly and controlled
• They should feel this exercise in the lower part of their calf muscles 

I usually recommend my clients to aim for is 3 sets of 12-15 repetitions again, however, this depends on your child's muscle strength to start with.

Exercise 3: Calf stretch

It is really common for young, growing, active children to have tight calf muscles.

This increases the strain on their heel and doesn’t allow your child’s calf muscles to function in an optimal way. 

Therefore stretching in combination with strengthening the calf muscle complex is a key component to your child’s off-season program.

Here are some important points for your child to remember when performing this exercise:

• Keep their back knee straight with the heels flat on the ground
• Your child’s feet must be pointing forward
• They should hold the stretch without bouncing 

You child should aim to perform this stretch for 3 sets of a 30-second hold on each leg.

How often should I exercise and when do I do more?

The current evidence suggests that for strengthening exercises to do them on alternate days (1 full day rest between sessions) to allow the tissue to heal and strengthen during the rest days.

I recommend to my clients to aim for 3-4 strengthening sessions per week.

Progression of exercises is extremely important to avoid plateauing.

Once your child is able to perform 12-15 of each exercise comfortably with good technique then they must progress.

This can be done by adding a 5kg weighted backpack.

It is also important to understand that when doing these exercises that your child may feel a little bit of discomfort however their pain should be no greater than 4/10 on a pain scale.

I Need More Information, What Should I Do?

It is important to realise the exercises above may not be suitable for all children and for all conditions.

If you are unsure about where to start a great first step is to book an appointment with one of the Complete Podiatry team.

The Podiatrists at Complete Podiatry are experts in lower limb mechanics and during your child's initial assessment, can find the causes contributing to the pain before developing an individualised management plan to get them stronger than they were pre-injury.

I'm so confident we can help you that I'd love to chat with you personally about your child's heel and foot pain, it's what I'm passionate about!