Will Severs Disease Need To Have Surgical Treatments?

Overview

The most common cause of heel pain in children is due to the disturbance or damage of the growth plate at the rear of the heel bone (Calcaneus). This condition is known as Sever?s disease or calcaneal apophysis. It occurs when an increased load is placed on the back of the heel from tension in the calf muscles, causing stress on the cartilaginous joint between the calcaneus and apophysis (growth plate). The condition is self-limiting and will cease when the two parts of the heel bone fuse together, however this may take up to a couple of years in some cases. There is no identified long term complications associated with Sever?s disease. Nevertheless, it is a painful condition that needs treatment when active to reduce pain levels and maintain activity levels of the child until the heel bone fuses into an adult bone.

Causes

Sever disease is more common in children who do regular sports or exercise that puts pressure on the heels. Activities such as running and jumping can put stress on the tight muscles and tendons.

Symptoms

Sever's Disease is most commonly seen in physically active girls and boys from ages 10 to 15 years old. These are the years when the growth plate is still ""open,"" and has not fused into mature bone. Also, these are the years when the growth plate is most vulnerable to overuse injuries, which are usually caused by sports activities. The most common symptoms of this disease include. Heel pain in one or both heels. Usually seen in physically active children, especially at the beginning of a new sports season. The pain is usually experienced at the back of the heel, and includes the following areas. The back of the heel (that area which rubs against the back of the shoe). The sides of the heel. Actually, this is one of the diagnostic tests for Sever's Disease, squeezing the rear portion of the heel from both sides at the same time will produce pain. It is known as the Squeeze Test.

Diagnosis

Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.

Non Surgical Treatment

Massage the calves gently from the knee to the heel, being especially careful around the Achilles? tendon, as this will be extremely tight and tender. During this massage, flex and point the foot through normal pain-free ranges of motion to increase flexibility while massaging. Massage every other or every third day, making sure your young athlete is not still sore before massaging again. If you?re unsure how to massage, find someone in your area that uses Graston technique or Active Release Therapy for best results. Stretch your athlete?s calves. This is the most overlooked aspect of treatment for Sever?s Disease and this needs to be done every day after practice, and when first starting we recommend 2-3 times per day, allowing gravity to pull heel down, never forcing the stretch. Ice your heels, but don?t just put an ice pack there. Use a cold water soak to fully immerse the foot and calves up to the knee. We recommend using a rubbermaid can found here. Soak for 10-15 minutes. The water does not have to be frigid, just cold. Use cold water from the tap, insert the foot, then add some ice to help bring down the temperature. When your athlete is experiencing pain, ice every hour, on the hour, for as many times as possible in one day. Make sure the heel/calves are body temperature before beginning again. Support the arches. This is what has been shown in studies to reduce pain in young athletes with Sever?s Disease. If you miss out on this one, you miss out on relieving your athletes pain.

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