Heel pain is common among children between the ages of 8 and 14 years old, and one cause of this condition is calcaneal apophysitis, also known as Sever’s disease. This condition arises due to the inflammation of the heel’s growth plate brought about by repetitive stress exerted on the heel bone. The growth plate, located at the back of the heel, is a weak area where new bone forms until the age of 14 when the heel bone is fully developed. Calcaneal apophysitis can affect either one or both feet and is considered the leading cause of heel pain in children.
Children and adolescents who participate in sports that involve running and jumping on hard surfaces, such as basketball, soccer, and track, are especially susceptible to calcaneal apophysitis. Other contributing factors to the condition include obesity, flatfoot or high-arched foot, and having a tight Achilles tendon.
Symptoms of calcaneal apophysitis include pain at the back or bottom of the heel, limping, walking on toes, difficulty running, jumping, or participating in usual activities, and pain when the sides of the heel are squeezed.
To diagnose the condition, a foot and ankle surgeon will examine the child’s foot and leg, obtain a thorough medical history, and inquire about recent activities to rule out other serious conditions. The surgeon is also likely to order X-rays and other advanced imaging studies and laboratory tests.
Treatment options for calcaneal apophysitis include reducing activity levels, providing support for the heel through temporary shoe inserts or custom orthotic devices, administering nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation, prescribing physical therapy to promote healing of the inflamed issue, and immobilizing the foot and ankle with a cast in severe cases.
To prevent calcaneal apophysitis from developing in children, parents can encourage their children to avoid obesity, opt for well-constructed, supportive shoes that are appropriate for their activity, limit wearing of cleated athletic shoes, and avoid activities beyond their ability.
It is worth noting that even after successful treatment, heel pain may recur if the growth plate is still developing. Recurrence of heel pain may indicate the return of calcaneal apophysitis or signal other problems. If a child experiences a repeat bout of heel pain, parents should make an appointment with a foot and ankle surgeon for proper diagnosis and treatment.
Dr Gilbert Huang DPM is an excellent foot and ankle surgeon who specializes in the diagnosis and treatment of calcaneal apophysitis. Parents who notice their children’s symptoms mirroring those of the condition should seek his expertise to provide the necessary intervention and prevent long-term heel pain.