It is the most common cause of heel pain in children, and can occur in one or both feet. Typically the pain resolves fairly quickly with conservative treatment.
Overuse and stress on the heel bone through participation in sports is a major cause of calcaneal apophysitis. The growth plate of the heel is sensitive to repeated running and pounding on hard surfaces, resulting in muscle strain and inflamed tissue. Children involved in soccer, tennis, or basketball are especially vulnerable.
Other potential causes of calcaneal apophysitis include a tight Achilles tendon, and biomechanical problems such as flatfoot or a high-arched foot.
- Pain in the back or bottom of the heel
- Walking on toes
- Difficulty running, jumping, or participating in sports
- Pain when the sides of the heel are squeezed
To diagnose the cause of the child’s heel pain and rule out other more serious conditions, we will take a thorough medical history and perform a detailed clinical exam. X-rays are often used to evaluate the condition and visualize the growth plate of the heel.
- Reduce activity. Reducing or stopping any activity that causes pain will help to decrease inflammation.
- Support the heel. Temporary shoe inserts, heel lifts, or custom orthotic devices may provide support for the heel.
- Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.
- Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue.
- Immobilization. In some severe cases immobilization with a cam walker boot may be needed for 4-6 weeks.