Characteristics of Pressure on the Apophysis in the Course of Paediatric Heel Pain—Preliminary Report

Aleksandra Bitenc-Jasiejko, Anna Walińska, Krzysztof Konior, Kinga Gonta, Piotr Skomro (), Konrad Kijak, Małgorzata Kowacka and Danuta Lietz-Kijak
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Aleksandra Bitenc-Jasiejko: Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland
Anna Walińska: PODOLOGIA.pl, FIKOU Physiotherapy, 44-100 Gliwice, Poland
Krzysztof Konior: Doctoral Study Department of Propaedeutic, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland
Kinga Gonta: Orthogenic Rehabilitation and Podology Center, 45-573 Wroclaw, Poland
Piotr Skomro: Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland
Konrad Kijak: Student Scientific Society at the Department and Clinic of Internal Diseases, Angiology and Physical Medicine, Medical University of Silesia, 40-055 Katowice, Poland
Małgorzata Kowacka: Independent Public Complex of Health Care, 42-300 Żarki, Poland
Danuta Lietz-Kijak: Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland

IJERPH, 2023, vol. 20, issue 7, 1-18

Abstract: Increased pressure on the heel apophysis is often implicated as a cause of paediatric heel pain. However, there are few reports on the causes of the increased pressure and its origin. Therefore, the aim of this study was to analyse the distribution of pressure on the feet in children with heel pain. The study included 33 paediatric patients with non-traumatic heel pain, i.e., 24 boys (73%) and 9 girls (27%), aged on average 11.2 years (±3 years). Pedobarographic diagnostics proved a decrease in the pressure on the heels in relation to the ground and the transfer of the projection of the centre of gravity to the forefoot. While standing, the average contribution of the pressure on the heel was 0.52, SD = 0.14 in children with normal and reduced weight. In overweight children, the average pressure on the heel was higher (0.60, SD = 0.08), but the small number of children with this characteristic ( n = 4) did not allow conclusions to be drawn in this area. Heel underload was also demonstrated during gait. However, the assessment of this aspect requires additional observational analyses in the field of propulsion and gait phases. The reduced pressure on the heel promotes apophysis traction, causing intracanal compression. Studies have shown that the causes of apophysis traction may be postural defects (in particular, forward inclination of body posture) and overpronation of the foot, or defects in the metatarsal area.

Keywords: Sever’s disease; osteochondritis dissecans (OCD); foot defects; postural disorders; pedobarography (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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