CALCANEAL APOPHYSITIS
This condition is seen more commonly in boys and between the ages of 10 and 11. However, this condition may also be seen in girls and age ranges anywhere between 8 and 15 depending upon the child's developmental bone growth.
The symptoms are pain at the back and bottom of the heel. Symptoms usually occur during and after activity and usually disappear with rest. Some children will be seen trying to walk on there tiptoes to prevent this pain.
Cause
Calcaneal apophysitis is due to an area in the heel bone that has not completely ossified (turned to bone). This happens in children because the growth plates in the bones have not hardened (see picture above). When the Achilles tendon or plantar fascia pulls on this area of the bone, it may become inflamed.
Prevention
Prevention is difficult as this occurs during a phase of growth that everyone must go through. Rest is the best prevention of the symptoms.
Treatment
Treatment is mainly supportive as the condition is usually self limiting. Usually as the child fully develops this area of the bone will eventually ossify and fuse with the main body of the bone. Treatment may include heel lifts to decrease the tension from the Achilles tendon, or complete non-weight bearing. Stretching exercises for the Achilles Tendon and Plantar Fascia are helpful at times as well as heat application before activity and ice after activity. Non-steroidal anti-inflammatories may also be prescribed. Treatment can be difficult at this age since they are typically patients who are athletic and enjoy the sport they play. The patient and their parents may not like hearing that they need to rest and quit playing the sport until this condition subsides.
If your child is experiencing any of these signs or symptoms, call today for an appointment.