We can often learn a good
deal about a particular medical condition if we understand the terminology
used in its description. The term, calcaneal, refers to the heel bone while
apophysitis describes an inflammation of the heel’s growth center in a
child. A calcaneal apophysitis is a condition usual\y seen in young athletic
or physically active children of the age group 8-15. The heel is painful
with running or jumping, is usually not swollen visually or discolored, and
seems to get progressively worse without treatment. A parent will often
bring in a child because of limping during game play along with complaints
by the child of discomfort in and around the heel especially after exercise.
What causes it?
Most authorities seem to
agree that this condition results from acute or repetitive trauma to the
heel at a time of vulnerability due to natural growth periods. The growth
plate is not solid bone but made of a softer substance. The Achilles tendon
attached to it and any increase in activity can cause the softer area to
move causing pain. It should be noted that the heel area of the foot is
under normal circumstances, not highly vascularized or well supplied by
blood circulation. This means that the area of the foot will heal slower and
might be subject to increased risk of injury. Acute trauma refers to a
sudden, impact or blow to the involved site while repetitive trauma involves
cumulative stress over an extended period of time. The bottom line is
similar however, with trauma to the growth plate area of the heel being the
culprit.
How do you treat it?
The management of a
calcaneal apophysitis condition involves protection and support of the heel
in order to allow for normal developmental growth. This can be accomplished
by padding the heel of the shoe, wearing protective cups, controlling heel
motion and impact with an orthopedic arch support and in some cases to even
further reduce weight bearing by casting and/or crutches. The continuance of
athletic competition during treatment is an issue that is largely dependent
upon how the child responds to therapy initially. In most cases, where the
symptoms reduce early on with treatment, the child d might continue with
physical activity. On the other hand, if the symptoms persist well into the
therapy period, then reducing or eliminating continued physical activity
might be necessary. This condition in most cases can be readily managed once
identified and properly treated. As the growth plate attaches to the bone
the condition becomes self limiting.
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