Updated: Jul 29, 2020
In this post we will explore some of the more common issues that can impact children and cause pain and inflammation in the foot. We provide details about both and what to do about them in the following post.
Calcaneal apophysitis, also known as “Sever’s Disease”, is an inflammation of the physis (growth plate) in the posterior calcaneus (heel bone). It is one of the most common causes of heel pain in children usually occurring between the ages of 8-14 years old. The growth plate is situated at the back of the heel near the insertion of the Achilles tendon. It is not fully developed until 14-years-old, therefore, this area is very prone to overuse injuries. Constant stress from the pull of the Achilles tendon, as well as repetitive pounding during activity, leads to inflammation of the growth plate and surrounding tissue. Children that are most at risk for calcaneal apophysitis are those participating in basketball, soccer, and/or track. Additional risk factors include a tight Achilles tendon, obesity, flat feet, or high arched feet. Symptoms often include pain to the back of the heel, feeling of being “tired”, pain with running/jumping, or pain with compression of the heel. It is a self-limiting condition and resolves at “closure” of the growth plate, usually around 14 years old. Therefore, treatment is usually symptomatic in nature and geared towards controlling inflammation and pain. Some treatment options include NSAIDs (non steroidal anti-inflammatory), oral steroids, stretching, physical therapy, custom orthotics, immobilization in walking boot or lower leg cast, and activity modification.
Apophysitis of the 5th metatarsal base, also known as “Iselin’s Disease”, is an inflammation of the physis (growth plate) that is located at the 5th metatarsal tuberosity. It is a common cause of lateral foot pain in physically active boys and girls. The most common age for onset of Iselin’s is between 8-13 years old. The inflammation is cause by excessive traction or pulling across the physis by the peroneal brevis tendon. Kids who are at an increased risk for Iselin’s are those who are physically active and participate in soccer, basketball, gymnastics, dancing, and sports with repetitive inversion stresses. The onset of Iselin’s is usually atraumatic in nature, beginning as an aching pain to the lateral foot which is worsened with activity and relieved with rest. There is usually tenderness to the base of the 5th metatarsal which may be accompanied by localized edema (swelling). Majority of cases of Islen’s are treated non operative and focused on decreasing inflammation and pain. Non-operative treatment consists of stretching, rest, activity modification, icing, cast immobilization, NSAIDs, oral steroids. In rare cases surgical excision may be required.
Be sure to get these issues checked out by one of the team at Gulf South Foot and Ankle to be properly diagnosed and treated.