Enrolling your child in sports is a proactive move to promote fitness, teamwork and social skills. But many parents are not prepared for the potential injury that is inherent in most sports. For children, one of the most common sports injuries is a repetitive motion injury to the growth plate of the heel bone.
Calcaneal Apophysitis
Calcaneal apophysitis, also known as Sever's disease, effects children between the ages of 8 and 14. More of a syndrome than a disease, calcaneal apophysitis is an inflammation of the calcaneus, or heel bone, at the growth plate. Growth plates are located at the ends of long bones and are the last place of the bone to harden, making them vulnerable to injury. In children, the growth plate regulates and determines the formation of the mature bone.
Causes of Calcaneal Apophysitis
The calcaneus is not fully developed until about 14 years of age. Repetitive stress like that incurred during active sports causes the Achilles tendon to pull on the still unhardened bone, resulting in inflammation and pain. Children involved in running and jumping sports like soccer, track and basketball are especially vulnerable. Calcaneal apophysitis is also common in figure and hockey skating, gymnastics, tennis and ballet. Obesity, tight Achilles tendons and flat or overly arched feet are other possible contributing causes.
Symptoms and Treatment
Symptoms of calcaneal apophysitis include limping, walking on the toes, an inability to run or play sports, and pain when the sides of the heel are squeezed. The first line of treatment for children's heel pain is to ensure that the growth plate has not been fractured. Because children's bones heal quickly, prompt attention to injuries and rapid intervention in the case of a fracture can prevent malformation of the bone. Once it has been ascertained that the pain is due to inflammation and not fracture, treatment by your health care provider may include reduced activity, orthotic shoe inserts, immobilization of the ankle, anti-inflammatory medications and physical therapy.
Preventative Measures
For any sport, athletic shoes that provide support and shock absorption serve as important safety equipment for injury prevention. Playing in worn or ill-fitting shoes can place your child at risk. Physical activity and balanced nutrition go hand in hand, particularly in sports that place a high demand on the body. Being overweight can place excessive loads on developing bones, muscles and joints. While participation in sports is generally beneficial for children, excessive competitiveness and overtraining can predispose any athlete to injury. Allowing your young athlete to take time off between playing seasons will give his or her body time to recover and grow.
References
- Foot Health Facts: Calcaneal Apophysitis (Sever's Disease)
- OandP.com: Competition; Pressure Fueling 'Overuse' Injuries in Young Athletes; March 23, 2006
- American Academy of Orthopaedic Surgeons: Growth Plate Fractures
- National Institute of Arthritis and Musculoskeletal and Skin Disease: Growth Plate Injuries
- Podiatry Today; Keys To Diagnosing And Treating Calcaneal Apophysitis; Russell G. Volpe, DPM; November, 2009
