As you are gearing up for the new school year, your children may be preparing for the possibility of fall, winter, and spring sports. With vigorous (and socially distanced) training, it is important to be aware of common podiatry issues that may arise so that you can quickly identify them and seek treatment as early as possible. This month we want to educate our patients on calcaneal apophysitis, a common source of heel pain in young athletes.
WHAT IS CALCANEAL APOPHYSITIS?
Calcaneal apophysitis, also known as Sever’s disease
, occurs when there is inflammation of the calcaneal growth plate in the heel. This condition mostly occurs in children between the ages of 8 and 14, as this is the period where the bones, muscles, and tendons are changing the most.
The most common cause of calcaneal apophysitis is repetitive stress on the heel area, specifically during sports activities and/or growth spurts. Young athletes are most prone to calcaneal apophysitis as running and jumping when muscles, tendons, and bones are not fully developed can cause this inflammation. This condition can be very painful, and nearly 60% of patients experience it in both heels.
OTHER CAUSES AND SYMPTOMS
While frequent trauma to the heel is one of the most common causes of calcaneal apophysitis, there are other factors that can contribute to this inflammation. Wearing unsupportive or worn out shoes and having tight lower leg muscles (specifically the calf and Achilles tendon) can also lead to inflammation of the growth plate. Cleated sports shoes can also cause direct irritation to the heel bone. Patients whose bones grow at a more rapid rate than the muscles and tendons may also experience calcaneal apophysitis.
It is important to note that children who are not athletes can still develop this condition, though it is more common in children who are physically active on a regular basis.
As previously mentioned, heel pain can occur in one or both feet. Typically, this pain is felt while the patient is engaging in activities that are common in sports such as running and jumping, but pain may also be present at other times such as when the heel is squeezed. At times walking may be painful, so it is not uncommon to have a limp.
HOW WE CAN HELP
We know it can feel so helpless to watch your child be in pain, and we are committed to helping him or her experience relief as soon as possible.
Depending on your child’s specific condition, we may recommend one or a combination of the following:
- Reduced activity for a period of time
- Rest and ice following any activity
- Anti-inflammatory medications that can be given as needed for pain relief
- A custom foot orthotic evaluation
- Hamstring, calf, and achilles tendon stretches
- Heel cups
- Physical therapy
- In some cases, a boot or cast to help immobilize the area while it heals
- Avoidance of going barefoot
Treatment time will vary patient to patient, and most athletes can return to their regular activities as pain subsides.