Children's Heel Pain

Calcaneal Apophysitis

Calcaneal Apophysitis is a painful inflammation of the growth plate in the heel of growing children. This condition primarily affects young active individuals, particularly those involved in high-impact sports like football, basketball, and gymnastics.

Causes of Calcaneal Apophysitis

Calcaneal apophysitis occurs when repetitive stress and overuse of the heel bone cause inflammation in the growth plate (apophysis). This condition is prevalent during periods of rapid growth, typically between the ages of 8 and 14. Key contributing factors include:

1. High-impact activities: Sports involving running, jumping, and sudden stops or starts place excessive stress on the heel.
2. Poor footwear: Inadequate or worn-out shoes that lack proper cushioning and support can exacerbate the condition.
3. Flat feet or high arches: Abnormal foot biomechanics increase the risk of heel pain.
4. Growth spurts: Rapid bone growth outpaces the development of muscles and tendons, leading to increased tension on the heel.

Symptoms of Calcaneal Apophysitis

The primary symptom of calcaneal Apophysitis is heel pain, which may be accompanied by:

• Tenderness and swelling: The affected heel may be tender to touch and slightly swollen.
• Pain during activity: Pain typically worsens with physical activity and improves with rest.
• Limping: Children may develop a noticeable limp to avoid putting pressure on the painful heel.
• Stiffness: Stiffness and discomfort may be present, especially after periods of inactivity.

Diagnosing Calcaneal Apophysitis

Diagnosis of calcaneal Apophysitis is primarily based on a clinical examination and the child’s medical history. Sometimes we may assess:

• Pain localisation: Tenderness at the back of the heel, near the growth plate.
• Activity correlation: Pain that worsens with physical activity and improves with rest.
• Imaging tests: X-rays are not usually necessary but may be used to rule out other conditions or confirm the diagnosis in unclear cases.
• Further tests and a thorough history: as well as carrying out further musculoskeletal tests, it is important to rule out any underlying medical conditions.