Iselin’s Disease

What Is Iselin’s Disease?

Iselin’s disease is a type of growing pain that affects the feet in children. Specifically, it affects the outside border of the foot at the bony ‘bump’ that you can feel if you move your hand along the outside edge of your foot. This bump is known as the ‘styloid process’, and it is located at the base of your fifth metatarsal bone, approximately halfway along the outer foot. Despite having an alarming label of a ‘disease’, Iselin’s is actually a painful but temporary growth-related condition that cannot recur after your bones reach maturity and stop growing.

In order to understand what causes Iselin’s disease, we need to first look at how bones grow. Before our bones mature, they contain specific cartilaginous areas called ‘growth plates’ which our body uses as a construction site to add new bone cells to, and hence grow our bones. Being a work in progress, these growth plates aren’t as strong as the rest of the bone, making them more vulnerable when tension is applied to the bone. 

While our bones grow, our muscles do too, lengthening and strengthening, and going through periods of tightness as they lengthen and keep up with the body’s growth. Many of these muscles attach to the bones, in areas close to the growth plates. This means that when the muscles pull and place tension on the bone while kids are moving and active, it’s the growth plates that become irritated and painful as a result. This is exactly what happens in Iselin’s disease, with the growth plate being present at that bony bump at the base of the fifth metatarsal, and the attaching tendon responsible for the pulling and irritation being the peroneus brevis tendon.

Iselin’s typically doesn’t have a notable injury history, trauma or infection that may otherwise explain the symptoms. If your child has Iselin’s disease, they may experience:

• Swelling on the outside of the midfoot
• Pain that eases with rest, is provoked by physical activity, and can come and go for weeks or months
• Limping or an altered gait pattern to try to reduce the pain and pressure on the outside of their foot

Can You Fix It?

Yes – despite many common misconceptions that nothing can be done about growing pains aside from waiting them out, because Iselin’s disease has a specific cause, we can use various techniques to address this cause – and hence reduce and stop the painful symptoms.

How Can You Fix It?

Our podiatrists are highly experienced in both working with children, and in managing growing pains through the feet and legs, including at the back of the heels, at the knees and at the midfoot. We’ll discuss all of the treatment options with you after completing a kids foot and leg assessment, so we can discuss the findings and what they mean for your child’s ability to stay active. We may use:

• Children’s foot orthotics to help reduce the strain on the muscle responsible for the pulling and hence pain. Often, this orthotic will include a small wedge on the outer edge. Your child’s orthotics will also have several other features that work together to optimally support their foot posture and function
• A stretching and strengthening exercises program that is child-friendly and easy to learn and follow at home. This is aimed at the calf and peroneal muscles, and designed to help reduce the tension on the foot and growth plate
• Footwear assessment to ensure your child’s footwear is supporting their recovery, and not contributing to the problem
• Padding and strapping for temporary symptoms relief
• Foot mobilisation to help support foot posture and ease any abnormal tension on the fifth metatarsal
• Education on how to modify physical activities to reduce pain and help limit irritation of the growth plate

While you’re at home, you may choose to use ice to help reduce any swelling, which can help reduce pain. If your child’s pain is severe, you may use painkillers (NSAIDs) to help relieve their pain. We also recommend they rest and avoid any activities that elicit your symptoms until you’re able to see your podiatrist.

FAQs

Who is most at risk for Iselin’s Disease?

Children and adolescents who are active in sports that involve frequent jumping or running are at a higher risk for Iselin’s Disease. Other factors that may increase the risk of Iselin’s Disease include foot and ankle instability, overpronation (excessive inward rolling of the foot during walking or running), and unsupportive footwear.

How is Iselin’s Disease diagnosed?

Iselin’s disease is diagnosed by our podiatrists after a comprehensive physical assessment.

How long does it take to recover from Iselin’s Disease?

With proper rest and treatment, most people with Iselin’s Disease can expect to recover within several weeks to a few months.

Can Iselin’s Disease cause long-term complications?

Only in rare cases, and if it’s not diagnosed and treated in a timely manner. Without treatment, Iselin’s may lead to chronic pain and inflammation in the affected foot, which can make it difficult to walk or engage in physical activity for some time.

How can Iselin’s Disease be prevented?

It is not always possible to prevent Iselin’s Disease, but there are some steps that can be taken to reduce the risk of developing this condition, such as:

• Wearing proper footwear that provides adequate support and cushioning can help reduce the stress on the foot and prevent injuries.
• Using proper technique when engaging in sports or other physical activities, which can help reduce the risk of foot injuries. For example, using proper form when jumping or landing can help reduce the stress on the foot.
• Proper warm-up and stretching before engaging in physical activity can help prepare the muscles and joints for the stress of exercise and reduce the risk of injury.
• Taking regular breaks during physical activity can help reduce the stress on the foot and prevent overuse injuries.
• Gradually increasing the intensity and duration of physical activity can help prevent injuries by allowing the body to adjust to the stress of exercise.
• Using orthotics can help support the foot and reduce the risk of injury.

Can Iselin’s Disease affect both feet?

Yes, Iselin’s Disease can affect both feet, although it is more commonly seen in only one foot. If the condition is caused by repetitive stress to both feet, such as from engaging in sports that involve a lot of running or jumping, then it is possible for both feet to be affected. However, it’s also possible for one foot to be affected first and then for the other foot to be affected later if the underlying cause of the condition is not addressed.

Are there any exercises or activities that should be avoided with Iselin’s Disease?

Ideally, you want to avoid activities that involve high-impact movements or repetitive stress on the foot, such as running, jumping, and playing sports like basketball, soccer, or tennis, should be avoided until the symptoms of Iselin’s Disease have completely resolved. In addition to high-impact activities, exercises that involve twisting or turning the foot, such as dance or martial arts, should also be avoided until the condition has healed.