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Diagnosis, Rehabilitation, and Training Load Monitoring Following Hematogenous Calcaneal Osteomyelitis in a
Erik A Wikstrom1, Stuart L Mitchell2, Joshua N Tennant2
1Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.
Abstract:
A 13-year-old male competitive club soccer player with a history of bilateral Osgood-Schlatter disease over the past 6 months reported unusually high fatigue and right heel pain after a match. Over the next 4 days, fever developed and persisted despite antipyretics. Right heel pain, warmth, and redness increased until weight-bearing was not tolerated. Subsequent imaging and blood work eventually lead to a calcaneal osteomyelitis diagnosis. A bone biopsy procedure and a 6-week course of antibiotics were completed. The rehabilitation and conditioning plan, which was successful, was based on assessment findings and targeted a return to sport 12 weeks postsurgery. Interprofessional collaboration was key for the diagnosis and effective medical treatment. Rehabilitation and conditioning protocol development was challenging as (1) no postsurgical rehabilitation protocol for a patient with calcaneal osteomyelitis wishing to return to sport has been described and (2) the impact of postinjury rehabilitation on training load is poorly documented.
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