What is Calcaneal Apophysitis?

A pophysitis occurs in the calcaneus when the heel of growth plate becomes severely inflamed. It is a condition that commonly affects children ages 8-14 often because the heel is not fully developed before vulnerable to repetitive stress. The condition is known as Sever's disease, which is a misnomer because it is not an actual disease. It is the most common form of foot pain in children, and can occur in one or both feet.

What Causes Calcaneal Apophysitis?

The vast majority of cases occurs from repetitive stress caused by sports. A child's growth plate is sensitive to the repeated pounding and running on hardened surfaces, which results in muscle strain and inflated tissue. Children involved in basketball, soccer and gymnastics are at highest risk.

There are other potential causes for Severs disease including obesity, biomechanical issues and a tightened Achilles' tendon.

Symptoms of Calcaneal Apophysitis

Symptoms of this painful condition include:

  • Pain in the bottom of the heel
  • Pain in the back of the heel
  • Limping caused by pain
  • Difficulty jumping and running
  • Walking on the toes

How is Severs Disease Diagnosed?

Calcaneal apophysitis is diagnosed through a variety of tests and exams. Foot and ankle doctors will typically conduct a verbal interview and a review of medical records. Typically an x-ray of the foot will be taken as well as possible laboratory tests.

How is Sever's Disease Treated?

There are a variety of treatment options for calcaneal apophysitis including:

Reduction in activity – this is the most common first treatment option where children stop the activity that is causing the pain.

Heel support – heel support such as shoe inserts and orthotics can be used to provide cushioning.

Medication – non-steroidal anti-inflammatory medications such as ibuprofen can reduce inflammation.

Physical therapy – stretching can be effective at promoting healing in the inflamed area

How can the Problem be Prevented?

The condition can be preceded by minimizing risk factors such as overuse, obesity and wearing cleats. It is important for children to be monitored closely when engaging in strenuous activity involving running on hard surfaces. Proper fitting footwear with excellent cushioning should always be worn.

As children continue to grow it is quite possible the foot pain can return. Should your child experience repeated bouts of foot pain it is important to see a doctor right away for a proper diagnosis and ways to minimize risk of permanent injury.