Discharge Instructions for 15-Year-Old with Calcaneal Apophysitis
For a 15-year-old with calcaneal apophysitis, palliative treatment is almost always successful and should include rest, activity modification, proper footwear, stretching exercises, and potentially orthotic devices. 1
Understanding the Condition
- Calcaneal apophysitis is the most common cause of heel pain in adolescents, particularly those active in running and jumping sports 1, 2
- The condition typically affects children between 8-15 years of age during growth spurts 3, 2
- No long-term effects have been associated with this condition 2
Immediate Pain Management
- Apply ice through a wet towel for 10-minute periods to reduce pain and inflammation 4, 3
- Consider over-the-counter NSAIDs for pain relief and reducing inflammation 4, 3
- Modify activities to avoid those that exacerbate pain, but complete rest is not necessary 4, 5
Footwear and Support Recommendations
- Wear shoes with proper fit, width, and cushioning that provide adequate arch support 4, 3
- Use heel cushions, heel lifts, or arch supports to redistribute weight and reduce pressure on the heel 4, 3, 6
- Consider custom or over-the-counter orthotic devices if pain persists 4, 6
Exercise and Stretching Program
- Perform regular calf muscle and Achilles tendon stretching exercises 3-5 times daily 4, 5, 3
- Begin eccentric strengthening exercises for the Achilles tendon once acute pain has subsided 4, 5
- Gradually return to sports activities as pain allows, avoiding sudden increases in training intensity 7, 3
Follow-up Care
- Expect improvement within 2 weeks to 2 months with consistent adherence to treatment recommendations 3, 8
- Return for follow-up if pain persists beyond 6-8 weeks despite following these instructions 9, 4
- Seek immediate medical attention if pain becomes severe or is accompanied by swelling, warmth, or inability to bear weight 1, 9
Important Precautions
- Avoid barefoot walking during the recovery period 1, 9
- Maintain proper foot hygiene and inspect feet daily for any signs of skin breakdown 1
- Weight management may be beneficial if applicable, as excess weight increases pressure on the heel 4, 5
Expected Outcomes
- Most patients respond well to conservative treatment within 6-8 weeks 3, 8
- Multiple treatment approaches (wait and see, heel raise inserts, or physical therapy) have all shown significant improvement in pain levels 8
- The condition is self-limiting and typically resolves completely with appropriate management 3, 2