What Is 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

Apart from age, other factors that may contribute to developing Sever?s disease include physical activity, any form of exercise that is weight bearing through the legs or stresses the soft tissue can exacerbate the pain of the disease, External factors, for example, running on hard surfaces or wearing inappropriate shoes during sport Overuse injury, very active children may repeatedly but subtly injure the bones, muscles and tendons of their feet and ankles. In time, the accumulated injuries cause symptoms.

Symptoms

The typical patient is a child between 10 and 13 years of age, complaining of pain in one or both heels with running and walking. The pain is localized to the point of the heel where the tendo-achilles inserts into the calcaneus (heel bone), and is tender to deep pressure at that site. Walking on his toes relieves the pain.

Diagnosis

Sever?s disease is diagnosed based on a doctor?s physical examination of the lower leg, ankle, and foot. If the diagnosis is in question, the doctor may order x-rays or an MRI to determine if there are other injuries that may be causing the heel pain.

Non Surgical Treatment

If your child is diagnosed with Sever's disease, treatment is fairly straightforward. He or she should avoid any activities that cause a flare-up of heel pain. Treat the pain with ice for 20 minutes, three times a day. If the pain is severe, over-the-counter pain relievers such as acetaminophen or ibuprofen can be used for a short period of time. (Don't use aspirin in a child or teen because it can result in a rare but life-threatening condition called Reye's syndrome.) In some instances, a child might have other foot problems, as well, such as high arches, flat feet, or bowed legs. In these instances, your doctor can recommend an orthotic device to help further prevent the pain related to Sever's disease. One other simple tip that can prevent Sever's disease or speed along recovery is for your child to wear supportive shoes and avoid going barefoot as much as possible.

Exercise

Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling, in which the foot is pointed away from the body, then curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever's disease. The curling exercise should be done in sets of 10 or 20 repetitions, and repeated several times throughout the day.

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