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DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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In my experience, calcaneal apophysitis generally does not present primarily as pain in the middle of the bottom of the heel, but I am not unconvinced, due to the other factors which I previously outlined, that such is not a prime candidate for the diagnosis. As I mentioned, x-rays are generally considered not terribly helpful, as most anything can be read into the viewing of even a normal growth center of the calcaneus. Accurate diagnosis can ususally be made on the basis of symptoms and circustances. It is generally advisable, though, that x-rays be taken, so as to rule out such other potential causes as stress fractures, cysts and tumorous growths. I am not aware of the use of sonograms as a diagnostic medium in this condition.
As I previously pointed out, one of the more difficult aspects of treatment is convincing the child to refrain from precipitating activities for a good deal of time, and when returning, to do it gradually. I frequently tell parents that if the child is not improving but, in spite of my admonishions, has continued to beat up on the area, they should not waste their money, as treatment is not likely to be effective.
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