{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T22:13:48Z","timestamp":1778624028815,"version":"3.51.4"},"reference-count":34,"publisher":"National Athletic Trainers' Association","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.4085\/1062-6050-0207.25","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:17Z","timestamp":1752537617000},"page":"857-862","source":"Crossref","is-referenced-by-count":1,"title":["Diagnosis, Rehabilitation, and Training Load Monitoring Following Hematogenous Calcaneal Osteomyelitis in a Competitive Adolescent Soccer Player: A Level 4 Case Report"],"prefix":"10.4085","volume":"60","author":[{"given":"Erik A.","family":"Wikstrom","sequence":"first","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart L.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of North Carolina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua N.","family":"Tennant","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of North Carolina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of North Carolina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April M.","family":"Wikstrom","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of North Carolina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"2","key":"i1938-162X-60-12-857-b01","series-title":"J Pediatr Orthop","first-page":"224","article-title":"Osteomyelitis of the calcaneus in children","volume":"16","author":"Puffinbarger","year":"1996","unstructured":"Puffinbarger WR,\nGruel CR,\nHerndon WA,\nSullivan JA. Osteomyelitis of the calcaneus in children. J Pediatr Orthop. 1996;16(2):224\u2013230. doi:10.1097\/00004694-199603000-00018"},{"issue":"6","key":"i1938-162X-60-12-857-b02","series-title":"J Pediatr Orthop","first-page":"699","article-title":"Hematogenous calcaneal osteomyelitis in children","volume":"19","author":"Jaakkola","year":"1999","unstructured":"Jaakkola J,\nKehl D. Hematogenous calcaneal osteomyelitis in children. J Pediatr Orthop. 1999;19(6):699\u2013704."},{"issue":"5","key":"i1938-162X-60-12-857-b03","series-title":"J Foot Ankle Surg","first-page":"840","article-title":"Antibiotic treatment and surgery for acute hematogenous calcaneal osteomyelitis of childhood","volume":"54","author":"P\u00e4\u00e4kk\u00f6nen","year":"2015","unstructured":"P\u00e4\u00e4kk\u00f6nen M,\nKallio MJ,\nPeltola H,\nKallio PE. Antibiotic treatment and surgery for acute hematogenous calcaneal osteomyelitis of childhood. J Foot Ankle Surg. 2015;54(5):840\u2013843. doi:10.1053\/j.jfas.2015.01.006"},{"issue":"3","key":"i1938-162X-60-12-857-b04","series-title":"Clin Med Res","first-page":"132","article-title":"Sever\u2019s disease of the pediatric population: clinical, pathologic, and therapeutic considerations","volume":"19","author":"Fares","year":"2021","unstructured":"Fares MY,\nSalhab HA,\nKhachfe HH,\nFares J,\nHaidar R,\nMusharrafieh U. Sever\u2019s disease of the pediatric population: clinical, pathologic, and therapeutic considerations. Clin Med Res. 2021;19(3):132\u2013137. doi:10.3121\/cmr.2021.1639"},{"issue":"2","key":"i1938-162X-60-12-857-b05","series-title":"Am Fam Physician","first-page":"86","article-title":"Heel pain: diagnosis and management","volume":"97","author":"Tu","year":"2018","unstructured":"Tu P. Heel pain: diagnosis and management. Am Fam Physician. 2018;97(2):86\u201393."},{"issue":"8","key":"i1938-162X-60-12-857-b06","series-title":"J Pediatr Orthop","first-page":"888","article-title":"Pediatric calcaneal osteomyelitis","volume":"30","author":"Leigh","year":"2010","unstructured":"Leigh W,\nCrawford H,\nStreet M,\nHuang M,\nManners S,\nPuna R. Pediatric calcaneal osteomyelitis. J Pediatr Orthop. 2010;30(8):888\u2013892. doi:10.1097\/BPO.0b013e3181fa7955"},{"key":"i1938-162X-60-12-857-b07","series-title":"J Med Case Rep","first-page":"185","article-title":"Delayed recognition of pediatric calcaneal osteomyelitis: a case report","volume":"9","author":"Mallia","year":"2015","unstructured":"Mallia AJ,\nAshwood N,\nArealis G,\nBindi F,\nZamfir G,\nGalanopoulos I. Delayed recognition of pediatric calcaneal osteomyelitis: a case report. 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J Pediatr Orthop. 1999;19(6):699\u2013704."},{"issue":"5","key":"i1938-162X-60-12-857-b03","series-title":"J Foot Ankle Surg","first-page":"840","article-title":"Antibiotic treatment and surgery for acute hematogenous calcaneal osteomyelitis of childhood","volume":"54","author":"P\u00e4\u00e4kk\u00f6nen","year":"2015","unstructured":"P\u00e4\u00e4kk\u00f6nen M,\nKallio MJ,\nPeltola H,\nKallio PE. Antibiotic treatment and surgery for acute hematogenous calcaneal osteomyelitis of childhood. J Foot Ankle Surg. 2015;54(5):840\u2013843. doi:10.1053\/j.jfas.2015.01.006"},{"issue":"3","key":"i1938-162X-60-12-857-b04","series-title":"Clin Med Res","first-page":"132","article-title":"Sever\u2019s disease of the pediatric population: clinical, pathologic, and therapeutic considerations","volume":"19","author":"Fares","year":"2021","unstructured":"Fares MY,\nSalhab HA,\nKhachfe HH,\nFares J,\nHaidar R,\nMusharrafieh U. Sever\u2019s disease of the pediatric population: clinical, pathologic, and therapeutic considerations. Clin Med Res. 2021;19(3):132\u2013137. doi:10.3121\/cmr.2021.1639"},{"issue":"2","key":"i1938-162X-60-12-857-b05","series-title":"Am Fam Physician","first-page":"86","article-title":"Heel pain: diagnosis and management","volume":"97","author":"Tu","year":"2018","unstructured":"Tu P. Heel pain: diagnosis and management. Am Fam Physician. 2018;97(2):86\u201393."},{"issue":"8","key":"i1938-162X-60-12-857-b06","series-title":"J Pediatr Orthop","first-page":"888","article-title":"Pediatric calcaneal osteomyelitis","volume":"30","author":"Leigh","year":"2010","unstructured":"Leigh W,\nCrawford H,\nStreet M,\nHuang M,\nManners S,\nPuna R. Pediatric calcaneal osteomyelitis. J Pediatr Orthop. 2010;30(8):888\u2013892. doi:10.1097\/BPO.0b013e3181fa7955"},{"key":"i1938-162X-60-12-857-b07","series-title":"J Med Case Rep","first-page":"185","article-title":"Delayed recognition of pediatric calcaneal osteomyelitis: a case report","volume":"9","author":"Mallia","year":"2015","unstructured":"Mallia AJ,\nAshwood N,\nArealis G,\nBindi F,\nZamfir G,\nGalanopoulos I. Delayed recognition of pediatric calcaneal osteomyelitis: a case report. J Med Case Rep. 2015;9:185. doi:10.1186\/s13256-015-0657-x"},{"issue":"2","key":"i1938-162X-60-12-857-b08","series-title":"Foot Ankle Int","first-page":"276","article-title":"Calcaneus osteomyelitis from community-acquired MRSA","volume":"28","author":"Lee","year":"2007","unstructured":"Lee MC,\nTashjian RZ,\nEberson CP. Calcaneus osteomyelitis from community-acquired MRSA. Foot Ankle Int. 2007;28(2):276\u2013280. doi:10.3113\/FAI.2007.0276"},{"key":"i1938-162X-60-12-857-b09","series-title":"Front Neurosci","first-page":"612","article-title":"Session-RPE method for training load monitoring: validity, ecological usefulness, and influencing factors","volume":"11","author":"Haddad","year":"2017","unstructured":"Haddad M,\nStylianides G,\nDjaoui L,\nDellal A,\nChamari K. Session-RPE method for training load monitoring: validity, ecological usefulness, and influencing factors. 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The relationship between internal and external loads as a tool to monitor physical fitness status of team sport athletes: a systematic review. Biol Sport. 2022;39(3):629\u2013638. doi:10.5114\/biolsport.2022.107021"},{"issue":"1","key":"i1938-162X-60-12-857-b12","series-title":"Sports Med Open","first-page":"6","article-title":"The association between training load and injury risk in elite youth soccer players: a systematic review and best evidence synthesis","volume":"7","author":"Verstappen","year":"2021","unstructured":"Verstappen S,\nvan Rijn RM,\nCost R,\nStubbe JH. The association between training load and injury risk in elite youth soccer players: a systematic review and best evidence synthesis. 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Monitoring the return to sport transition after ACL injury: an alpine ski racing case study. Front Sports Act Living. 2020;2:12. doi:10.3389\/fspor.2020.00012"},{"issue":"9","key":"i1938-162X-60-12-857-b15","series-title":"J Athl Train","first-page":"973","article-title":"Lower extremity movement quality and the internal training load response of male collegiate soccer athletes","volume":"56","author":"Condon","year":"2021","unstructured":"Condon TA,\nEckard TG,\nAguilar AJ,\nFrank BS,\nPadua DA,\nWikstrom EA. Lower extremity movement quality and the internal training load response of male collegiate soccer athletes. 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