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Calcaneal Apophysitis in Adults & Children

Instructor: Alyssa Campbell

Alyssa is an active RN and teaches Nursing and Leadership university courses. She also has a Doctorate in Nursing Practice and a Master's in Business Administration.

Calcaneal apophysis is a painful condition causing inflammation to the heel's growth plate. Read this lesson to learn more about this condition, common signs and symptoms, and how to treat it.

Pain in the Heels

Steven is a 10-year-old soccer star on a regional team. He spends most of his free time practicing with his teammates and doesn't sit still for long. Over the past few weeks, Steven's father Joe, noticed that his son was running a little slower than usual and having difficulty focusing on the game.

Joe is worried that Steven no longer wants to play soccer, and sits down with him to talk. Turns out Steven is having a lot of pain in his heels. Worried that Steven might have an injury, Joe makes an appointment with the doctor for a check-up.

Calcaneal Apophysitis

Immediately upon learning of Steven's heel pain, the physician, Dr. Carlo, suspects calcaneal apophysitis, a common source of heel pain in children ages eight to fourteen. Also known as Sever's disease, this condition tends to affect boys more often than girls.

Dr. Carlo also explains that during adolescence, the physis, or growth plate, of the foot is growing and creating new bone that may cause pain in one or both heels. Additionally, inflammation and irritation to the physis may occur due to constant use of the feet, especially in children who play sports requiring lots of walking or running.

Symptoms of Calcaneal Apophysitis

After explaining the possibility of calcaneal apophysitis as the cause of Steven's pain, Dr. Carlo moves forward to complete a physical assessment and learn more about his symptoms. The signs and symptoms of calcaneal apophysitis include:

  • Pain at the heel, especially when pinched
  • Limping
  • Walking on tips of toes to avoid pain
  • Tiredness
  • Avoidance of activities like sports that require a lot of time on the feet

An X-ray of the heel bone

An X-ray is taken to confirm the calcaneal apophysitis and to rule out other conditions like heel bone fracture.

Treating Calcaneal Apophysitis

Even though Steven loves his favorite sport, he continues to have pain in his heels. To effectively treat his condition, Dr. Carlo recommends the following plan.

First, she recommends an orthotic insert for Steven's shoes. This is a padded piece used to absorb shock and prevent discomfort in the foot when placed appropriately inside the shoe. The orthotic can be used temporarily until the inflammation subsides.

In most adolescent cases, calcaneal apophysitis does not resolve and continues to cause pain in children until the bone is fully grown. To further treat the pain, the following is recommended:

  • Decreased activity
  • Physical therapy
  • Application of a hard cast to immobilize the foot

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