Vertical ground reaction forces during gait in children with and without calcaneal apophysitis.
BACKGROUND
Heightened vertical load beneath the foot has been anecdotally implicated in the development of activity-related heel pain of the calcaneal apophysis in children but is supported by limited evidence.


RESEARCH QUESTION
This study investigated whether vertical loading patterns during walking and running differed in children with and without calcaneal apophysitis.


METHODS
Vertical ground reaction force, peak plantar pressure (forefoot, midfoot, heel) and temporospatial gait parameters (cadence, step length, stride, stance and swing phase durations) were determined in children with (n = 14) and without (n = 14) calcaneal apophysitis. Measures were acquired during barefoot walking and running at matched and self-selected speed using an instrumented treadmill, sampling at 120 Hz. Statistical comparisons between groups were made using repeated measure ANOVAs.


RESULTS
There were no significant between group differences in vertical ground reaction force peaks or regional peak plantar pressures. However, when normalised to stature, cadence was significantly higher (≈ 5%) and step length shorter (≈ 5%) in children with calcaneal apophysitis than those without, but only during running (P <.05). Maximum pressure beneath the rearfoot during running was significantly correlated with self-reported pain in children with calcaneal apophysitis.


SIGNIFICANCE
Peak vertical force and plantar pressures did not differ significantly in children with and without calcaneal apophysitis during walking or running. However, children with calcaneal apophysitis adopted a higher cadence than children without heel pain during running. While the findings suggest that children with calcaneal apophysitis may alter their cadence to lower pressure beneath the heel and, hence pain, they also highlight the benefit of evaluating running rather than walking gait in children with calcaneal apophysitis.
['McSweeney|Simon|S|', 'Reed|Lloyd F|LF|', 'Wearing|Scott C|SC|']
D000293:Adolescent D001696:Biomechanical Phenomena D002111:Calcaneus D016022:Case-Control Studies D002648:Child D005080:Exercise Test D005260:Female D005534:Foot Diseases D005684:Gait D006801:Humans D008297:Male D012420:Running D016138:Walking
Ground reaction force Heel pain Paediatric Sever’s disease