How You Can Treat Calcaneal Apophysitis

Overview
Also known as calcaneal apophysitis, Severs? disease is a condition that primarily affects children between the ages of 7 and 15. The condition is typified by pain in the heel which can affect movement, and as a foot condition, comes under the care of podiatrists. Podiatrists are specially trained professionals who specialise in any and all ailments of the foot and ankle. Podiatrists dealing with Severs? disease are typically podopaediatricians, individuals who have received training in the delivery of childhood care.

Causes
Heel pain is very common in children because of the very nature of their growing feet and legs. In children, the heel bone (the calcaneus) is not fully developed until the age of 14 or older. Until then, new bone is forming at the growth plate of the foot (the apophysis, located at the back of the heel), an area which is softer than others due to its role in accommodating the growth. Repetitive stress on the growth plate due to walking, running and sports causes inflammation in the heel area. Because the heel's growth plate is sensitive, repeated running and pounding on hard surfaces can result in pediatric heel pain. Children and adolescents involved in football, soccer, running or basketball are especially vulnerable. Over-pronation (fallen arches and rolling inwards of the feet) will increase the stress on the growth plate and is therefore a significant cause and a major contributing factor to heel pain in children.

Symptoms
This is a condition that affects the cartilage growth plate and the separate island of growing bone on the back of the heel bone. This growth plate is called the physeal plate. The island of growing bone is called the apophysis. It has the insertion attachment of the Achilles tendon, and the attachment of the plantar fascia. This island of bone is under traction from both of these soft tissue tendon and tendon-like attachments.

Diagnosis
Sever?s disease Can you grow taller with exercise? be diagnosed based on the symptoms your child has. Your child?s doctor will conduct a physical examination by squeezing different parts of your child?s foot to see if they cause any pain. An X-ray may be used to rule out other problems, such as a broken bone or fracture.

Non Surgical Treatment
Treatment may consist of one or more of the following. Elevating the heel. Stretching hamstring and calf muscles 2-3 times daily. Using R.I.C.E. (Rest, Ice, Compression, Elevation). Foot orthotics. Medication. Physical therapy. Icing daily (morning). Heating therapy. Open back shoe are best and avoid high heel shoe. The Strickland Protocol has shown a positive response in patients with a mean return to sport in less than 3 weeks. Further research into the anatomical and biomechanical responses of this protocol are currently being undertaken.

Surgical Treatment
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.