Will Calcaneal Apophysitis Require Surgery?

posted on 19 May 2015 16:06 by swankyparish9906
Overview

Heel pain can also occur in children, most commonly between ages 8 and 15, as they become increasingly active in sports activity in and out of school. This physical activity, particularly jumping, inflames the growth centers of the heels, also known as the apopyhsis. The more active the child, the more likely the condition will occur. Your doctor may also describe the condition as Sever's Disease or calcaneal apophysitis.

Causes

Sever's disease is caused by repetitive tension and/or pressure on the growth center of the heel. Running and jumping place a large amount of pressure on the heels and can cause pain. Children with Sever's may limp or have an altered gait due to the pain. Risk factors for Sever's include tight calf muscles, weak ankle muscles, and alignment abnormalities at the foot and ankle. Sever's can also result from wearing shoes without sufficient heel padding or arch support.

Symptoms

Symptoms include heel pain related to sports activities and worsen after those sport and exercise activities. However, some children who are not in a sport may also get this if they are physically active. If you notice that your child is ?walking on their toes? this is a sign of possible heel pain. The pain is usually on the back of the heel, the sides of the heel, the bottom of the heel, or a combination of all of these. We typically don't see swelling with this, however if pressure is applied to the sides of the heel pain may be reported. Sometimes the pain is so bad the child will have to limp, or take a break from sports activity either for a few days or few months.

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

Occasionally, an orthotic may need to be prescribed for temporary or long-term correction of their foot biomechanics (eg flat feet or high arches). During the acute phase of Sever's disease a small heel rise or shock-absorbing heel cup placed under the heel pad of your child's foot may help to ease the symptoms. Your podiatrist or physiotherapist can assess your child's arch and guide you in the best management of your child's condition. We recommend that your child should never go barefooted during the painful stages of Sever's disease.

Prevention

Treat symptoms when they occur with RICE and NO HARM. RICE (Rest Ice, Compression and Elevation) will help following activity and when symptoms flare, while No HARM (No Heat, alcohol, running or massage) will help reduce the symptoms from occurring. Orthotics. The use of an Interpod Orthotic will assist in realigning the foot, which will reduce the stress on the Achilles Tendon and prevent reoccurring symptoms. The orthotic achieves this by reducing the forces and stress placed on the limbs during walking and running. Exercise reduction. Patients may need to reduce their level of activity if this is seen as a contributing factor. Training errors. Ensue athletes warm up and cool down correctly with stretching activities. Footwear. Sporting and school shoes should have an appropriate heel height to assist in offloading of the Achilles tendon.