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With year-round sports becoming more common for kids of all ages, we are seeing an uptick in the number of sports injuries we treat each year. Calcaneal apophysitis is not an injury, but it is closely tied to growing children who are physically active. Explore this major cause of heel pain in kids with us to find out what you can do if it strikes your child.

Because the heel can grow faster than the tendons during a growth spurt (pre-teen years), the tendons can become tight and stretched. This causes them to pull against the bone and irritate the growth plate, which becomes inflamed and painful. There is usually no swelling or redness associated with the problem, but there is often tenderness when the back of the heel is pinched slightly.

It is believed that the shear from the trauma of landing on the heel as the child runs, augmented by the pull of the tight Achilles, causes fragmentation in the structure of the growth plate. The chief symptom is pain during activity. This will often recede when the child is resting, but come back again after more activity.

The problem is considered to be an overuse syndrome. It is associated with children who play soccer, basketball, gymnastics, and other sports that involve running. Children with weight problems may be more at risk, too. Many with the condition also have more difficulty lifting up the front of the foot (less dorsiflexion at the ankle). They may have either flat feet or high arches and an abnormal pronation pattern as well.

With that in mind, the best treatment pearls are:

  • Have your child rest from activity to allow bone and tissue to heal
  • Ice the area to reduce pain
  • Establish a stretching routine to loosen your child’s calf muscles and Achilles
  • Use heel orthotics to decrease the tension on the Achilles

Three to six weeks of this regimen will eliminate the pain and allow your child to return to sports activity. Continued stretching can keep the problem from returning, and eventually all the bones and tendons will reach full growth and the problem goes away.

We love it when kids are active, but if your child has characteristics that put them more at risk, it will be worth the time and effort to do the stretching program to head off problems before they start. Southern California Foot & Ankle Specialists can help you with that. Just call our office in Ladera Ranch, CA at (949) 364-9255 (WALK) to set up a time to talk with us.