Definition
Calcaneal apophysitis
- overuse injury
- stress fracture in secondary growth center of calcaneum
Epidemiology
4/1000
Boys > girls
10 - 12
Bilateral in 40%
Etiology
Sports / overuse
Limited ankle dorsiflexion
Clinical
Mechanical heel pain
Tender calcaneum
Restricted ankle dorsiflexion
Xray
Management
Nonoperative
Rest
NSAID
Tendoachilles stretching
Orthotics
- heel raises
- custom made heel orthotics
Results
Heel raise / physio versus no treatment
Wiegerinck et al J Pediatr Orthop 2016
- 101 patients randomized to heel raise / physio / no treatment
- better outcomes with heel raise and physio
Heel raise versus orthotics
Alfaro-Santafe et al Children 2021
- RCT of heel lift versus custom orthotics in 208 patients
- improvement in both groups
- better improvement with custom orthotics
James et al Br J Sports Med 2016
- RCT of heel raises versus custom orthotics in 124 patients
- no difference