Other Causes of Foot Pain

Sever’s disease/Calcaneal apophysitis –an inflammation of the calcaneal apophysis in the area of heel cord insertion. Generally manifests as pain in the posterior calcaneus in the 6-10 year-old age group. Direct palpation shows tenderness. A tight heel cord contributes to or exacerbates this condition. Treatment is activity modification, NSAIDs, and heel cord stretching exercises.  Also see Achilles tendinosis
  1. An apophysis is a growth plate that does not contribute to the length of the bone. The growth plate is weak and subject to micro-injury.
  2. the achilles tendon inserts into the calcaneal apophysis.
  3. Radiographic evaluation is usually normal.
  4. Sever’s Disease (like Osgood-Schlatter disease of the tibial tuberosity) is an overuse syndrome seen in adolescents during their growth spurt.
  5. The most common sports to exacerbate heel pain are soccer, basketball, gymnastics and baseball, especially sports that involve sprinting with cleated shoes.
  6. Exam reveals tenderness over the lateral and medial sides of the calcaneal apophysis and decreased dorsiflexion of the ankle without swelling or redness. Findings are bilateral in 60%.
  7. Treatments:


CHLA Board Review 2005