Severs Disease The Facts

Posté par unadvisedcyst1302 le 21 May 2015

Overview

Another name for Sever?s Disease is calcaneal apophysitis. The heel bone is called the calcaneus. Sever?s Disease is heel pain thought to be caused by inflammation around the growth plate in the calcaneus (apophysis). It is most likely due to repetitive overuse during sports and exercise, which causes increased strain on the heel growth plate. Sever?s Disease won?t cause long-term damage or arthritis. Sever?s Disease is often associated with tight heel tendons. It most commonly affects physically active children who are between the ages of 8, 14 years old, such as soccer players and gymnasts.

Causes

Mechanically, the heel takes a beating. And the apophyseal bone is located near the point of impact for the heel bone at heel strike and with most weight bearing activities. This includes running, jumping and walking. Heavy impact activities like soccer, football and gymnastics are commonly associated with this problem. In addition to this, there is traction on this apophyseal bone and the associated physeal line of growth cartilage. This traction on the apopysis (island of bone) along with the impact of weight bearing activities can lead to inflammation and pain. Tight Achilles and calf muscles also can contribute to this problem, and why stretching is discussed later.

Symptoms

The most prominent symptom of Sever’s disease is heel pain which is usually aggravated by physical activity such as walking, running or jumping. The pain is localized to the posterior and plantar side of the heel over the calcaneal apophysis. Sometimes, the pain may be so severe that it may cause limping and interfere with physical performance in sports. External appearance of the heel is almost always normal, and signs of local disease such as edema, erythema (redness) is absent. The main diagnostic tool is pain on medial- lateral compression of the calcaneus in the area of growth plate, so called squeeze test. Foot radiographs are usually normal. Therefore the diagnosis of Sever’s disease is primarily clinical.

Diagnosis

Sever?s disease can be diagnosed based on the symptoms your child has. Your child?s doctor will conduct a physical examination by squeezing different parts of your child?s foot to see if they cause any pain. An X-ray may be used to rule out other problems, such as a broken bone or fracture.

Non Surgical Treatment

A doctor, sports therapist or physiotherapist can apply a plaster cast or boot if the child is in severe pain. This may be worn for a few days or even weeks and should give relief of pain for a while. Carry out a full biomechanical assessment. This may help to determine if any foot biomechanics issues are contributing to the condition. Orthotics or insoles can be prescribed to help correct over pronation or other biomechanics issues. Prescribe anti-inflammatory medication such as ibuprofen to reduce pain and inflammation. This will not be prescribed if asthma the child has asthma. In persistent cases X-rays may be taken but this is not usual. A doctor, sports therapist or physiotherapist will NOT give a steroid injection or operate as these are not suitable treatment options. The condition will usually settle within 6 months, although it can persist for longer.

Prevention

To prevent Sever’s Disease, fit your child with kid’s shoes with good cushioning in the footbed, shock absorption in the heel, and support in the outsole. Make sure children wear supportive shoes, especially when they’re running and jumping, to reduce the impact on the heel and strain on the developing bone and muscle structure of a kids’ feet. Children’s arch supports and heel cups comfortably support the foot and encourage healthy alignment while your child runs or walks.

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