AKA calcaneal apophysitis

• Common cause of heel pain

• Age 7-10

• Achilles tendon exerts tensile forces on calcaneal apophysis

• Soccer most common sport

• Symptoms worse @ start of season or growth spurt

Examination

• point tenderness insertion of achilles tendon

• tight heel cords - limited dorsiflexion

• heel pain with medial-lateral compression

Investigation

• XR look normal

Treatment

• Non operative:

• activity/shoe modification

• padded heel cups

• calf stretches

• condition settle 6-12 months; occasionally 2 years

• strengthening exercises for ankle plantar felxors commenced when pain free

• Steroid/surgery contraindicated

Persistent pain should have other conditions considered:

• Achilles tendinopathy

• Plantar fasciitis

• Calcaneal stress fracture