Heel pain – Pediatric (Sever’s Disease / Calcaneal Apophysitis)
If you don’t know what’s wrong, how can you fix it?
The image below is a 3D CT scan of the foot showing the back of the heel with ankle bone aligned on the heel bone compared to the partial dislocation of the ankle bone. Notice how the heel is vertically aligned with the lower leg bone when the ankle bone is aligned. When the ankle bone partially dislocates from the heel bone, the bottom of the heel bone turns outward.
Then we put the foot into motion to see how the heel abnormally shifts secondary to the ankle bone displacement.
The reason why the growth plate gets inflamed is the pulling and twisting of the bone on the back of the heel. When the child is walking or running, the Achilles tendon is pulling the bone in one direction and the arch tissue – the plantar fascia – is pulling in a different direction.