Calcaneal epiphysitis in adolescent athletes.

Twenty cases of calcaneal epiphysitis are reviewed. Six females and fourteen males presented with the complaint of heel pain which was bilateral in 80% of the cases. All patients were active in running-related sports. The mean age was 11.2 years (9-14) and symptoms had been present, on the average, for 5.5 months. Physical examination placed particular emphasis on the alignment of the leg and foot. Clinically the pain was localized to the insertion of the achilles tendon to the calcaneal epiphysis. Biomechanical evaluation revealed marked genu varus - 6 cases; forefoot varus - 10 cases. Treatment consisted of modified rest and ice massage - all cases; new shoes with medial support and rigid heel counters - 10 cases; heel lifts - 6 cases; soft orthotics - 15 cases; and semiflexible sporthotics - 2 cases. Response to the treatment was generally good with 75% of patients having a reduction in symptoms in 1 month and 95% by 3 months.