While injuries are unfortunately part of being an athlete, young athletes often encounter injuries that are unique and age-specific. The foot and ankle is a common source of these injuries.
The most common foot and ankle injury found among young athletes is a condition called calcaneal apophysitis, also known as Sever’s disease. This condition most commonly presents in children ranging from 8 to 14, and can occur whether the athlete is playing on turf, grass, or courts. The main complaints include soreness along the back of the heel bone and discomfort along the course of the Achilles’ tendon. In some kids, the pain is present during activity while in other children the pain occurs after completion of activity.
Calcaneal apophysitis occurs when the tibia (leg bone) grows in length, which causes the calf muscles to tighten. Ultimately the Achilles’ tendon pulls on the growth plate in the back of the heel bone and creates inflammation.
The goal of treatment is to stretch the calf muscles so the Achilles’ tendon stops pulling on the growth plate and the inflammation reduces. This is most often done with the assistance of a physical therapist and/or athletic trainer. Icing the heel after activity and stretching, as well as anti-inflammatory medication can also help speed the healing process. Though in most cases young athletes may continue competing in their sport, in some rare cases patients are placed on restrictions.
Stress fractures are also a common injury in athletes of all ages. In the foot and ankle, the most common bones to see a stress injury include the metatarsal bones (which connect the toes to the foot) and the calcaneus (heel bone).
Stress fractures occur when the inside of the bone becomes fatigued due to overuse. Although they are common in runners, all types of athletes can present with a stress fracture. Symptoms of a stress fracture include soreness in a particular spot of the foot. There may be instances where there is swelling or bruising, although each case will have its own unique presentation. The diagnosis occurs through physical exam and X-rays. Because stress injuries occur on the inside of the bone, there are instances where the X-ray will appear normal initially and an MRI may be used for diagnosis.
Treatment for a stress fracture includes immobilization of the foot with either a walking boot or a cast; crutches may or may not be needed. Typically patients will have X-rays every two to three weeks. Once it is determined that healing has occurred, the athlete will work with the physical therapist to regain strength and progress back to full activity.
While injuries are a part of sports, an important way to prevent injuries of the foot and ankle is to ensure young athletes are wearing the appropriate type of well-fitted shoe for the sport. It is also important to make sure the shoes are able to function and are replaced as needed.