APOPHYSITIS
Unlike
the heel spurs that occur in adults, heel pain is very unusual in
children. For the children who do get heel pain, the most common
cause is an irregularity to the growing area at the back of the heel
bone where the large achilles tendon attaches to it. This is called
Calcaneal Apophysitis (an inflammation of the growth plate). It
occurs most often to children between the ages of 10 to 14.
The Development of Heel Pain:
Most of
the bones are still cartilage when a baby is born. Only some are
developing into bone. When the heel starts to develop bone, there is
usually a large area of growth that begins in the middle of the
cartilage heel. This area of bone spreads and expands into cartilage.
Ossification, another area of bone development happens at the back of
the heel bone. The two areas of developing bone will have cartilage
between them - this is how the bone grows in size. At about 16 years
of age, the growth is nearly complete, these two bony areas merge
together.
Symptoms of Heel Pain in the Child:
In
severe cases, the child will be limping. The back and side of the
heel bone will have discomfort. Also, there may be pain at the
bottom of the heel. The pain usually stops when the child is not
active and becomes painful with physical activity. Pinching the sides
of the heel bone is often painful. Running, jumping make the symptoms
worse. One or both heels may be affected.
The Cause:
It is
most likely due to repeated trauma that happens in a lot of sporting
activities - the cartilage join between the two parts of the bone can
not take all the shear stress of the activities. Some children seem
to be just more prone to it for an unknown reason - combine this with
sport, especially if its on a hard surface and the risk of getting it
increases. It can be almost epidemic at the start of some sports
seasons, especially winter. At the start of winter, the grounds are
often harder, but soften later.
Treatments:
* Minimize
physical activities - don't stop, just reduce the amount until
symptoms improve.
* Do
not go barefoot
* Use a
soft cushioned heel raise.
*
Stretch the calf muscles provided the stretch does not cause pain.
* Ice
the area for 20 minutes after the activity, can be done 2 to 3 times
a day.
What
your Podiatrist may do:
Strapping
or taping can be used during activity to restrict the ankle joint
range of motion.
If the
symptoms are bad enough and not responding to these treatments,
medication to help with anti-inflammatory may be used. In some cases
the lower limb may need to be put in a cast for 2-6 weeks to give it
a good chance to heal.
Get a
good supportive shock absorbing shoe at our Sole Savers Shoe Store
and heel raises are important to prevent it from happening again.
