Archive for the ‘Severs Disease’ Category

Severs Disease Physical Therapy

Overview

Sever’s Disease, otherwise known as calcaneal apophysitis is an inflammation of the growth plate in the heel of growing children, typically adolescents. The condition presents as pain in the heel and is caused by repetitive stress to the heel and is thus particularly common in active children. It usually resolves once the bone has completed growth or activity is lessened.

Causes

During the growth spurt of early puberty, the bones often grow faster than the leg muscles and tendons. This can cause the muscles to become very tight and overstretched, the heel becomes less flexible and this build-up of pressure can result in redness, swelling, tenderness and pain at the heel.

Symptoms

Symptoms include complaints of pain or tenderness in the heel (or heels), discomfort when heel is squeezed, limping, and more severe pain after walking, running or playing sports. Sever?s disease is directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves lots of heel movements and hard shoes such as cleats. It can be associated with starting a new sport, or the start of a new season. It occurs more commonly in children who pronate (feet roll inward), and involves both heels in more than half of patients.

Diagnosis

Low-grade inflammation of the calcaneal apophysis cannot be seen on x-ray. Therefore, although x-rays are often done to rule out bony injuries in children with Sever’s disease these x-rays are usually normal. Advanced Sever’s disease can be seen on x-ray but usually the problem is treated before it reaches this point. Other diagnostic tests, such as bone scans or MRI’s, are not usually required in typical cases of Sever’s disease. These, or other tests, may be required to rule out other conditions, such as stress fractures of the calcaneus or other bony abnormalities that can mimic Severs disease.

Non Surgical Treatment

Rest is best to allow healing .Only do as much exercise as able without causing pain. Many children can continue to play sports but if pain is severe then stopping the activity may be the only way to allow the pain to settle. The child might be able to do things that do not put pressure on the heel, such as swimming and cycling. Ice and cold therapy may be useful to reduce pain and swelling, particularly following activity or sport. The area should be iced until it feels cold not ?frozen?. Never apply ice directly onto the skin, as this may cause tissue damage. Medication. The following will help treat your child?s pain. Paracetamol (see bottle for instructions) Ibuprofen (see bottle for instructions). Exercises, perform foot and leg exercises to stretch and strengthen the leg muscles & tendons. Increase calf flexibility by doing calf stretches several times per day. Protect the heel, your shoes might need a heel lift or arch support. Select a shoe with good arch support and heel lift if possible. Take it one step at a time: gradually resume running and impact activities as symptoms allow.

Prevention

Can Calcaneal Apophysitis Be Prevented? The chances of a child developing heel pain can be reduced by avoiding obesity. Choosing well-constructed, supportive shoes that are appropriate for the child?s activity. Avoiding or limiting wearing of cleated athletic shoes. Avoiding activity beyond a child?s ability.

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Posted May 18, 2015 by lilliamferlic in Severs Disease

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