Does Severs Disease Need Surgical Treatments?

posted on 19 May 2015 07:46 by dailypolitics3021
Overview

Sever?s disease is caused by the growth plate in the heel becoming inflamed, and it is the most common cause of heel pain in adolescents. This condition is especially prevalent in children who play sports. Treatment includes ice, rest, and pain relievers to manage pain and discomfort. Any underlying foot conditions may also need to be assessed and managed. Sever?s disease does not cause any permanent damage, and will resolve when the growth of the heel is complete. Sever?s disease (also called calcaneal apophysitis) is a condition that occurs in the growth plate of the heel bone (the calcaneus) in children and adolescents. When the muscles and tendons in the leg and heel exert too much pressure on this growth plate, swelling and pain can result.

Causes

There are several factors which may increase the likelihood of developing this condition. These need to be assessed and corrected with direction from a physiotherapist to ensure an optimal outcome. Some of these factors include inappropriate footwear, calf tightness and/or weakness, joint stiffness (particularly the foot and ankle), poor lower limb biomechanics, inappropriate or excessive training, inadequate recovery periods from training or activity, inappropriate training surfaces, inadequate warm up, poor core stability, a lack of lower limb strength and stability, poor proprioception or balance, rapid growth and age.

Symptoms

Unilateral or bilateral heel pain. Heel pain during physical exercise, especially activities that require running or jumping or are high impact. Pain is often worse after exercise. A tender swelling or bulge on the heel that is painful on touch. Limping. Calf muscle stiffness first thing in the morning.

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

See a Podiatrist. Minimise inflammation, by the use of ice, rest and reduction of activity. Minimise pain with the use of anti-inflammatory medications. Shoes have been shown to attenuate shock and reduce impact on the heel. Effective cushioning in the rear through specifcally placed cushioning units, such as GEL under the heel. A 10mm heel gradient that creates a more efficient foot posture and therefore reducing strain on the lower limb. Sever's is self limiting and only possible when the growth plate is still present, and does not exist once the growth plates have closed. Podiatrists have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.