Severs Disease The Truth

Published on

Overview

Severs Disease is a common cause of heel pain in children. It is seen most commonly in children aged 5 - 11 years old. Children with Severs Disease will complain of heel pain that increases with activity. The pain is often relieved by rest, although some children will continue to have pain with regular activities, such as walking. Severs Disease has much in common with Osgood-Schlatter Disease. Both are described as being a traction apophysitis.

Causes

Physically active children run the risk of developing Sever?s disease because they put the most strain on their growing bones. Sever?s usually occurs during the adolescent growth spurt, when young people grow most rapidly. (This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys.) By age 15 the back of the heel usually finished growing. As teens grow, the growth plates harden and the growing bones fuse together into mature bone. Young people engaged in physical activities and sports that involve jumping and running on hard surfaces-such as track, basketball, soccer, and gymnastics-are ata higher risk for developing Sever?s disease. Poor-fitting shoes can contribute by not providing enough support or padding for the feet or by rubbing against the back of the heel.

Symptoms

Typically, the sports injury occurs where the achilles tendon attaches to the bone. The epiphyseal growth plate is located at the end of a developing bone where cartilage turns into bone cells. As the growth center expands and unites, this area may become inflamed, causing severe pain when both sides of the heel are compressed. There is typically no swelling and no warmth, so it?s not always an easy condition to spot. The child usually has trouble walking, stiffness upon waking, and pain with activity that subsides during periods of rest.

Diagnosis

In Sever's disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or she runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that your child's heel tendons have become tight.

Non Surgical Treatment

Sever?s disease is a self-limiting problem, because as your child grows the growth plate will eventually fuse with the main body of the heel bone. This happens at about 14 -15 years of age. Once foot growth is complete and the growth plate has fused, the symptoms will resolve. In the meantime, treatment by your Podiatrist will help your child return to normal sporting activities without heel pain slowing him/her down.

Exercise

The following exercises are commonly prescribed to patients with Severs disease. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should be performed 1 - 3 times daily and only provided they do not cause or increase symptoms. Your physiotherapist can advise when it is appropriate to begin the initial exercises and eventually progress to the intermediate, advanced and other exercises. As a general rule, addition of exercises or progression to more advanced exercises should take place provided there is no increase in symptoms. Calf Stretch with Towel. Begin this stretch in long sitting with your leg to be stretched in front of you. Your knee and back should be straight and a towel or rigid band placed around your foot as demonstrated. Using your foot, ankle and the towel, bring your toes towards your head as far as you can go without pain and provided you feel no more than a mild to moderate stretch in the back of your calf, Achilles tendon or leg. Hold for 5 seconds and repeat 10 times at a mild to moderate stretch provided the exercise is pain free. Calf Stretch with Towel. Begin this exercise with a resistance band around your foot and your foot and ankle held up towards your head. Slowly move your foot and ankle down against the resistance band as far as possible and comfortable without pain, tightening your calf muscle. Very slowly return back to the starting position. Repeat 10 - 20 times provided the exercise is pain free. Once you can perform 20 repetitions consistently without pain, the exercise can be progressed by gradually increasing the resistance of the band provided there is no increase in symptoms. Bridging. Begin this exercise lying on your back in the position demonstrated. Slowly lift your bottom pushing through your feet, until your knees, hips and shoulders are in a straight line. Tighten your bottom muscles (gluteals) as you do this. Hold for 2 seconds then slowly lower your bottom back down. Repeat 10 times provided the exercise is pain free.

Comment on this post