What Is Calcaneal Apophysitis?

Overview

Sever?s disease is a common cause of heel pain in children especially in the young and physically active. Severs disease is a painful bone disorder that results from inflammation (swelling) of the growth plate in the heel. A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite. It is very important that damage to the growth plate is avoided.

Causes

Overuse and stress on the heel bone through participation in sports is a major cause of calcaneal apophysitis. The heel?s growth plate is sensitive to repeated running and pounding on hard surfaces, resulting in muscle strain and inflamed tissue. For this reason, children and adolescents involved in soccer, track, or basketball are especially vulnerable. Other potential causes of calcaneal apophysitis include obesity, a tight Achilles tendon, and biomechanical problems such as flatfoot or a high-arched foot.

Symptoms

Sever condition causes pain at the back of the heel. The pain is increased with plantar flexion of the ankle (pushing down with the foot as if stepping on the gas), particularly against resistance. Sever condition also causes tenderness and swelling in the area of the pain.

Diagnosis

To diagnose the cause of the child?s heel pain and rule out other more serious conditions, the foot and ankle surgeon obtains a thorough medical history and asks questions about recent activities. The surgeon will also examine the child?s foot and leg. X-rays are often used to evaluate the condition. Other advanced imaging studies and laboratory tests may also be ordered.

Non Surgical Treatment

For patients suffering from Sever’s disease, the pediatric orthopaedic surgeon will often recommend a conservative treatment plan including anti-inflammatory medication (as directed by the doctor). Application of ice to the heel. Calf, hamstring, and heel stretches. Orthotics. Modification of activities. There are rarely any complications with the treatment of Sever’s disease, and symptoms generally resolve within 2 weeks to 2 months. Patients can typically return to playing sports again after the heel pain has resolved. The physician will let confirm when it is safe to resume physical activities.

Exercise

Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever’s disease. An exercise known as foot curling, in which the foot is pointed away from the body, then curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever’s disease. The curling exercise should be done in sets of 10 or 20 repetitions, and repeated several times throughout the day.

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