Apophysitis

Apophysitis

Unlike the heel spurs that occur in adults, heel pain is very unusual in children. For the children who do get heel pain, the most common cause is an irregularity to the growing area at the back of the heel bone where the large achilles tendon attaches to it. This is called Calcaneal Apophysitis (an inflammation of the growth plate). It occurs most often to children between the ages of 10 to 14.

THE DEVELOPMENT OF HEEL PAIN:

Most of the bones are still cartilage when a baby is born. Only some are developing into bone. When the heel starts to develop bone, there is usually a large area of growth that begins in the middle of the cartilage heel. This area of bone spreads and expands into cartilage. Ossification, another area of bone development happens at the back of the heel bone. The two areas of developing bone will have cartilage between them - this is how the bone grows in size. At about 16 years of age, the growth is nearly complete, these two bony areas merge together.

SYMPTOMS OF HEEL PAIN IN THE CHILD:

In severe cases, the child will be limping. The back and side of the heel bone will have discomfort. Also, there may be pain at the bottom of the heel. The pain usually stops when the child is not active and becomes painful with physical activity. Pinching the sides of the heel bone is often painful. Running, jumping make the symptoms worse. One or both heels may be affected.

THE CAUSE:

It is most likely due to repeated trauma that happens in a lot of sporting activities - the cartilage join between the two parts of the bone can not take all the shear stress of the activities. Some children seem to be just more prone to it for an unknown reason - combine this with sport, especially if its on a hard surface and the risk of getting it increases. It can be almost epidemic at the start of some sports seasons, especially winter. At the start of winter, the grounds are often harder, but soften later.

TREATMENTS:

* Minimize physical activities - don't stop, just reduce the amount until symptoms improve.

* Do not go barefoot

* Use a soft cushioned heel raise.

* Stretch the calf muscles provided the stretch does not cause pain.

* Ice the area for 20 minutes after the activity, can be done 2 to 3 times a day.

What your Podiatrist may do:

Strapping or taping can be used during activity to restrict the ankle joint range of motion.

If the symptoms are bad enough and not responding to these treatments, medication to help with anti-inflammatory may be used. In some cases the lower limb may need to be put in a cast for 2-6 weeks to give it a good chance to heal.

Get a good supportive shock absorbing shoe at our Sole Savers Shoe Store and heel raises are important to prevent it from happening again.