The Running Doctor: Growth plate injuries
Soccer players, as well as those involved in all running sports, often complain of heel pain. This problem is caused by a condition known as apophysitis of the calcaneus (heel bone) or "Sever's Disease."
The condition consists of an inflammation of the growth area (or heel plate) of the heel bone when it has not completely matured or closed together, and therefore has developed in two parts. The patient will complain of pain in the area directly behind the heel and lower than the Achilles' tendon.
It is commonly seen in boys and girls between the ages of 10-15. The pain usually presents in the area of the heel, and is more pronounced in running and jumping sports. Sometimes there is a limp in the child's gait of which he may not even be aware.
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This has been described as an osteochondrosis, which is a loss of blood supply to the apophasis. In some cases, if not treated, this condition can result in adulthood pain. In the older athlete, the complaint will be under the heel bone and arch area.
Some of the causes of growth plate injury include trauma, biomechanical foot imbalance of abnormal pronation of the foot (inward rolling and flattening of the foot), a high arch foot, cleated or improperly fitting shoes and improper training methods.
In summary, watch for any warning signals when young and mature athletes complain of heel pain. There is usually a need for examination.
Robert F. Weiss is a podiatrist specializing in foot and ankle surgery. He was a member of the Medical Advisory Committee of the 1984 and 1988 Olympic Marathon Trials. Weiss is a veteran of 35 marathons and has a practice in Darien: The Foot & Ankle Institute of Darien. For more information, visit www.therunningdoctor.net.