What Causes Calcaneal Apophysitis?

posted on 23 May 2015 16:48 by exclusivebough91
Overview

Sever's Disease, otherwise known as calcaneal apophysitis is an inflammation of the growth plate in the heel of growing children, typically adolescents. The condition presents as pain in the heel and is caused by repetitive stress to the heel and is thus particularly common in active children. It usually resolves once the bone has completed growth or activity is lessened.

Causes

Sever?s disease is most likely to occur during the growth spurt that occurs in adolescence. For girls, growth spurts usually occurs between 8 and 13 years of age. For boys, it?s typically between 10 and 15 years of age. The back of the heel hardens and becomes stronger when it finishes growing, which is why Sever?s rarely occurs in older adolescents and teenagers.

Symptoms

Sever's disease usually develops gradually. The pain from Sever's disease is often intermittent and localized to the area where the Achilles tendon attaches to the calcaneus. Swelling may be noted in this area. There can be tenderness on squeezing the calcaneus or pain when trying to stretch the calf muscles. Occasionally there is night pain. As Sever's disease progresses there can be continuous pain.

Diagnosis

A physical exam of the heel will show tenderness over the back of the heel but not in the Achilles tendon or plantar fascia. There may be tightness in the calf muscle, which contributes to tension on the heel. The tendons in the heel get stretched more in patients with flat feet. There is greater impact force on the heels of athletes with a high-arched, rigid foot.

Non Surgical Treatment

Depending on the Podiatrist's diagnosis and the severity of the pain, there are several treatment options available. Rest/ reduced activity: your child should reduce or stop any activity that causes pain, such as sports and running. This can be a difficult option, as children are normally quite willful in pursuit of their favorite pastimes! Over the counter anti-inflammatory drugs, such as ibuprofen (found in Nurofen), to help reduce pain and inflammation. Try to make sure your child does the recommended stretching exercises before sport/play. This will should help reduce the stress on the fascia tendon and relieve heel pain. The use of Orthotic insoles. Footactive Kids orthotics are made for children. They will help properly support the foot, help prevent over-pronation or improper gait restoring your child's foot the the correct biomechanical position. If you are in any doubt or your child's foot pain persists then please arrange an appointment with a Podiatrist or Physiotherapist. Please click here for more information on the use of orthotics for children.

Prevention

After the painful symptoms of Sever's disease have gone away, it is important to continue stretching the heel, particularly before a vigorous exercise, and wearing good supportive shoes fitted with children's arch supports. This will prevent heel pain recurrence until the child's heel is fully developed and less prone to injury.