What Would Cause Severs Disease?

Overview

If you?re a young basketballer/netballer/footballer and have heel pain when playing basketball or sports involving running or jumping, you may have a particular growth pain disorder called Sever?s Disease. It is a condition (not a disease) usually affecting 9-15 year olds that occurs at the back of the heel, where the Achilles tendon attaches to the foot. The Achilles tendon is the tendon connected to the calf muscles. Pulling of the calf muscles results in tension in the Achilles and in adolescents, repeated running/jumping can result in pain and inflammation at the heel, this is called Sever?s Disease.

Causes

Contraction of the calf muscles along with the rapid growth of the leg bone (tibia), decreases ankle motion and increases strain on the heel area. This puts strain on the Achilles tendon. Injury results from repetitive pulling through the heel bone by the Achilles and the traction forces from the plantar fascia.

Symptoms

Some of the common symptoms of Sever's disease are pain in one or both heels with running and walking. The pain is originates from the point of the heel where the tendo-achilles inserts into the heel bone. Heel pain that goes away when resting. Swollen heel. Calf muscle stiffness first thing in the morning.

Diagnosis

Low-grade inflammation of the calcaneal apophysis cannot be seen on x-ray. Therefore, although x-rays are often done to rule out bony injuries in children with Sever's disease these x-rays are usually normal. Advanced Sever's disease can be seen on x-ray but usually the problem is treated before it reaches this point. Other diagnostic tests, such as bone scans or MRI's, are not usually required in typical cases of Sever's disease. These, or other tests, may be required to rule out other conditions, such as stress fractures of the calcaneus or other bony abnormalities that can mimic Severs disease.

Non Surgical Treatment

If your child have Sever's disease, the following is suggested, cut back on sporting activities, don't stop, just reduce the amount until symptoms improve (if the condition has been present for a while, a total break from sport may be needed later) avoid going barefoot, a soft cushioning heel raise is really important (this reduces the pull from the calf muscles on the growth plate and increases the shock absorption, so the growth plate is not knocked around as much). Stretch the calf muscles, provided the stretch does not cause pain in the area of the growth plate). The use of an ice pack after activity for 20mins is often useful for calcaneal apophysitis - this should be repeated 2 to 3 times a day.

Recovery

Severs disease is a self limiting condition that gradually resolves as the patient moves towards skeletal maturity. This usually takes between 6 to 12 months, but may persist for as long as 2 years. With appropriate management, symptoms may resolve in a number of weeks. Patients with Severs disease typically improve gradually over time and full function is restored.

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