Rochell Weser
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Find Out How To Diagnose Calcaneal Apophysitis?
Overview


Sever?s disease is irritation of the growth plate in the heel. If rest is prescribed by your doctor, you should probably listen! But, there is usually an underlying cause of this irritation, and we need to address what?s causing it if we don?t want it to come back the first time an athlete jumps, runs, or kicks a ball.


Causes


There are several theories surrounding the cause of Sever?s disease. These range from a tight Achilles tendon, to micro stress fractures of the heel, to biomechanical mal-alignment, to trauma, to flat feet, and even to obesity. But the prevailing theory suggests the onset of Sever?s disease occurs when the child's growth plate is at its weakest, while a tightened Achilles tendon pulls repeatedly on the growth plate, such as during AGS.


Symptoms


The patient complains of activity related pain that usually settles with rest. On Examination the heel bone - or calcaneum - is tender on one or both sides. The gastrocnemius and soleus muscles (calf muscles) may be tight and bending of the ankle might be limited because of that. Foot pronation (rolling in) often exacerbates the problem. There is rarely anything to see and with no redness or swelling and a pain that comes and goes mum and dad often wait before seeking advice on this condition. The pain may come on partway through a game and get worse or come at the end of the game. Initially pain will be related only to activity but as it gets worse the soreness will still be there the next morning and the child might limp on first getting up.


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


When the condition flares, it is treated with activity limitation, medication to reduce inflammation (such as ibuprofen [Advil] or naproxen [Aleve]), shoe inserts, heel lifts, cold packs, and sometimes casting when it becomes especially severe. Sever condition is generally a self-limited problem that usually improves within a year.


Prevention


Maintain good flexibility through stretching exercises. Avoid excessive running on hard surfaces. Use quality, well-fitting shoes with firm support and a shock-absorbent sole.
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