Will Severs Disease Have To Have Surgical Treatments?

posted on 20 May 2015 03:45 by verenarondeauu
Overview

Sever's disease, also known as calcaneal apophysitis, is an inflammatory condition of the growth plate of the heel (calcaneus). Sever's disease is seen during periods ofSever's_Disease_x-ray active bone growth, particularly between the ages of 10 and 14 years old. Sever's disease is a self limiting condition, meaning that all cases of Sever's disease will disappear once bone growth is finalized and the growth plate of the heel closes. Skeletal maturity and closure of the growth plate occurs for most children at 15-16 years of age. The onset of Sever's Disease is insidious and found more in boys than girls.

Causes

The heel bone grows faster than the ligaments in the leg. As a result, muscles and tendons can become very tight and overstretched in children who are going through growth spurts. The heel is especially susceptible to injury since the foot is one of the first parts of the body to grow to full size and the heel area is not very flexible. Sever?s disease occurs as a result of repetitive stress on the Achilles tendon. Over time, this constant pressure on the already tight heel cord can damage the growth plate, causing pain and inflammation. Such stress and pressure can result from, Sports that involve running and jumping on hard surfaces (track, basketball and gymnastics). Standing too long, which puts constant pressure on the heel. Poor-fitting shoes that don?t provide enough support or padding for the feet. Overuse or exercising too much can also cause Sever?s disease.

Symptoms

Pain is reproduced through a gentle squeeze of the back of the heel. Children may present with a limp or ?Bouncy gait?. Pain is worse barefoot and often present in the mornings and post exercise. The pain is located at the back of the heel, with localized swelling of the area.

Diagnosis

Radiography. Most of the time radiographs are not helpful because the calcaneal apophysis is frequently fragmented and dense in normal children. But they can be used to exclude other traumas. Ultrasonography. could show the fragmentation of secondary nucleus of ossification of the calcaneus in severs?s disease. This is a safe diagnostic tool since there is no radiation. This diagnostic tool can also be used to exclude Achilles tendinitis and/or retrocalcaneal bursitis.

Non Surgical Treatment

Reduce activity, avoid going barefoot, and cushion the child's heel with shock absorbency. It is very important that your child wear shoes with padded heel surfaces and shoes with good arch supports even when not participating in sports. A heel cup or soft pediatric shoe insert is very important to reduce the pull from the calf muscles on the growth plate and to increase shock absorption and reduce irritation. The use of an ice pack after activity for 20 minutes is often useful. Your health care provider may also prescribe anti-inflammatory drugs or custom orthotics.

Recovery

With proper care, your child should feel better within 2 weeks to 2 months. Your child can start playing sports again only when the heel pain is gone. Your doctor will let you know when physical activity is safe.