Will Severs Disease Always Demand Surgical Treatment?

posted on 23 May 2015 14:26 by marshallejtgflsrsh
Overview

Children with Sever's disease, which is also called calcaneal apophysitis, develop microfractures where the Achilles tendon inserts on the calcaneus, the large bone that makes up the heel of the foot. These microfractures cause pain, which can vary depending on the type of activity your child is doing, and is generally worse after activity and improves with rest. Sever's disease is more common in boys and typically occurs when a child is between 8 and 13 years old. Although it can affect both heels, it more commonly just affects one foot.

Causes

Overuse and stress on the heel bone through participation in sports is a major cause of calcaneal apophysitis. The heel?s growth plate is sensitive to repeated running and pounding on hard surfaces, resulting in muscle strain and inflamed tissue. For this reason, children and adolescents involved in soccer, track, or basketball are especially vulnerable. Other potential causes of calcaneal apophysitis include obesity, a tight Achilles tendon, and biomechanical problems such as flatfoot or a high-arched foot.

Symptoms

Some of the most common signs and symptoms associated with Sever?s disease include. Heel pain or tenderness in one or both heels, usually at the back of the heel. Pain or discomfort upon waking, or when the heel is squeezed. Heel pain that is worse during or following activity. Limping. Heel swelling or redness. Tight calf muscles. Decreased ankle range of motion.

Diagnosis

The doctor may order an x-ray because x-rays can confirm how mature the growth center is and if there are other sources of heel pain, such as a stress fracture or bone cyst. However, x-rays are not necessary to diagnose Sever?s disease, and it is not possible to make the diagnosis based on the x-ray alone.

Non Surgical Treatment

There are several things we can do to treat Sever?s disease and ease the discomfort. Special shoe inserts, such as heel pads or cups, can act as a shock absorber, decrease pressure on the heel bone and slightly elevate the heel to relieve the pain. Elastic wraps and compression stockings can help decrease any swelling and pain. We also show kids some specific stretches that can help stretch the calf muscles and tendons on the back of the leg to reduce stress on the heel. We might also recommend rest, applying ice, elevating the foot, and over-the-counter pain medication.

Exercise

Stretching exercises can help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should do these stretches 2 or 3 times a day. Each stretch should be held for about 20 seconds. Both legs should be stretched, even if the pain is only in 1 heel. Your child also needs to do exercises to strengthen the muscles on the front of the shin. To do this, your child should sit on the floor, keeping his or her hurt leg straight. One end of a bungee cord or piece of rubber tubing is hooked around a table leg. The other end is hitched around the child's toes. The child then scoots back just far enough to stretch the cord. Next, the child slowly bends the foot toward his or her body. When the child cannot bend the foot any closer, he or she slowly points the foot in the opposite direction (toward the table). This exercise (15 repetitions of "foot curling") should be done about 3 times. The child should do this exercise routine a few times daily.