Physiotherapy And Calcaneal Apophysitis

posted on 14 May 2015 17:27 by aberrantquagmir17
Overview

It is important to know that foot pain is not only limited to grown-ups. Often active, healthy children will complain of pain in one or both heels shortly after walking, running, engaging or playing sports. The pain is usually felt at the back of, or under the heel. The cause of heel pain in children is usually a condition called calcaneal apophysitis or Sever's Disease, normally reported by 8 to 14 year olds.

Causes

Sever's disease is a common cause of heel pain in physically active growing kids. It usually occurs during the growth spurt of adolescence, the approximately 2-year period in early puberty when kids grow most rapidly. This growth spurt can begin anytime between the ages of 8 to 13 for girls and 10 to 15 for boys. Peak incidences are girls, 8 to 10 years old. boys, 10 to 12 years old.

Symptoms

Unilateral or bilateral heel pain. Heel pain during physical exercise, especially activities that require running or jumping or are high impact. Pain is often worse after exercise. A tender swelling or bulge on the heel that is painful on touch. Limping. Calf muscle stiffness first thing in the morning.

Diagnosis

All medical diagnosis should be made by taking a full history, examining the patient then performing investigations. The problem usually occurs in boys who are going through or have just gone through a growth spurt; one or both heels may be affected. Initially the pain may be intermittent occurring only during or after exercise. As the problem gets worse, pain may be present most of the time. There may be swelling over the back of the heel and this area is painful if touched or knocked. On examination the patient often has flat feet, very tight legs muscles especially the gastrocnemius.

Non Surgical Treatment

Treatment includes modifying activities and resting to reduce pain and inflammation and take pressure off the growth center. Ice can also be very helpful in relieving symptoms, as well as anti-inflammatory medication. A physical therapy program should be initiated to stretch tight calf muscles and strengthen the ankle muscles to relieve tension on the growth center. Shoes with padded heel surfaces and good arch support can decrease pain. Cleats may need to be avoided for some time to help reduce symptoms. The doctor may also recommend gel heel cups or supportive shoe inserts.

Prevention

Properly stretching to maintain flexibility is effective for preventing Sever's disease. Stretches should target the calves, heel cords, and hamstrings. Your child should do the appropriate stretches two or three times a day, holding the stretch for about 20 seconds each time. Ask your child's doctor for specific exercise instructions. Generally, doctors advise stretching both legs, even if the pain is confined to one heel. It's also helpful to strengthen the shin muscles by having your youngster pull his toes in with a rubber exercise band or a piece of tubing and then stretch them forward. Assist your child in doing 15 repetitions of this exercise, three times a day. Having your child wear shoes with good shock absorbers and avoid running on hard surfaces as much as possible should also help prevent the condition.