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Key Features

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  • Also called calcaneal apophysitis

  • Occurs in athletes aged 8–12 years who are typically involved in high-impact activities, such as gymnastics and soccer

  • Causes

    • Overuse

    • Improper footwear

    • Tightness in the calf musculature and Achilles tendon

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Clinical Findings

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  • Pain occurs about the heel and at the point of muscle tendon insertion onto the growth center of the calcaneus

  • Athlete complains of activity-related heel pain

  • Examination reveals focal tenderness over the calcaneal apophysis

  • Tenderness created by pressing forcefully on the lateral and medial heel constitutes a positive "calcaneal squeeze test"

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Diagnosis

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  • Clinical

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Treatment

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  • Symptomatic

    • Reassurance and education

    • Relative rest

    • Heel cord stretching

    • Eccentric calf strengthening

    • Ice massage

    • Heel cups

    • Nonsteroidal anti-inflammatory drugs for pain control

    • Progression to activity as tolerated based on pain level

  • Activity restriction is not required

  • Refractory cases may benefit from brief immobilization and partial or non–weight bearing in a walking boot or cast followed by supervised physical therapy

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