What Exactly Is Severs Disease?

Overview

During AGS, and in specific reference to Sever?s disease, the heel bone grows faster than the Achilles tendon, resulting in an extremely tight Achilles tendon. Because the foot is one of the first parts of the body to grow to full size, and because the heel is not a very flexible area, it is especially susceptible to injury. The Achilles tendon (also called the heel cord) is the strongest tendon that attaches to the growth plate in the heel. Over time, repeated stress (such as impact activities) on the tight Achilles tendon causes the tendon to pull on and damage the growth plate in the heel, resulting in swelling, tenderness, and pain.

Causes

Apart from the age of the young person, other factors that may contribute to developing the disease may include; overuse or too much physical activity. Your child?s heel pain may be caused by repeated stress on the heels (running and jumping activities), pressure on the back of the heel from too much standing or wearing poor-fitting shoes. This includes shoes that do not support or provide enough padding for your child?s feet.

Symptoms

Sever condition causes pain at the back of the heel. The pain is increased with plantar flexion of the ankle (pushing down with the foot as if stepping on the gas), particularly against resistance. Sever condition also causes tenderness and swelling in the area of the pain.

Diagnosis

Sever disease is most often diagnosed clinically, and radiographic evaluation is believed to be unnecessary by many physicians, but if a diagnosis of calcaneal apophysitis is made without obtaining radiographs, a lesion requiring more aggressive treatment could be missed. Foot radiographs are usually normal and the radiologic identification of calcaneal apophysitis without the absence of clinical information was not reliable.

Non Surgical Treatment

Cold packs: Apply ice or cold packs to the back of the heels for around 15 minutes after any physical activity, including walking.

Shoe inserts: Small heel inserts worn inside the shoes can take some of the traction pressure off the Achilles tendons. This will only be required in the short term.

Medication: Pain-relieving medication may help in extreme cases, but should always be combined with other treatment and following consultation with your doctor).

Anti-inflammatory creams: Also an effective management tool.

Splinting or casting: In severe cases, it may be necessary to immobilise the lower leg using a splint or cast, but this is rare.

Time: Generally the pain will ease in one to two weeks, although there may be flare-ups from time to time.

Correction of any biomechanical issues: A physiotherapist can identify and discuss any biomechanical issues that may cause or worsen the condition.

Education: Education on how to self-manage the symptoms and flare-ups of Sever?s disease is an essential part of the treatment.

Recovery

If the child has a pronated foot, a flat or high arch, or another condition that increases the risk of Sever's disease, the doctor might recommend special shoe inserts, called orthotic devices, such as heel pads that cushion the heel as it strikes the ground, heel lifts that reduce strain on the Achilles tendon by raising the heel, arch supports that hold the heel in an ideal position, If a child is overweight or obese, the doctor will probably also recommend weight loss to decrease pressure on the heel. The risk of recurrence goes away on its own when foot growth is complete and the growth plate has fused to the rest of the heel bone, usually around age 15.

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