Does Severs Disease Require Surgery?

Overview

Sever?s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain In one or both feet. The disease is known to affect children between the ages of 8 and 14. Sever?s disease occurs when part of the child?s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes. Toe gait- develops in which the child must change the way they walk to avoid placing weight on the heel. This can lead to other problems as well in the future.

Causes

The cause of Sever's Disease is not entirely clear but it is most likely due to repeated minor trauma that occurs during high-impact activities that involve running and jumping such as soccer, basketball, and gymnastics. It may also occur when an active child regularly wears shoes with poor heel padding, shock absorbency, or poor arch support. Some additional contributing factors are excessive pronation, an overly tight calf muscle, and other flaws in the biomechanics of a child's walking stride. Children who are overweight are also at greater risk of developing Sever's Disease.

Symptoms

Sever?s disease is more common in boys. They tend to have later growth spurts and typically get the condition between the ages of 10 and 15. In girls, it usually happens between 8 and 13. Symptoms can include pain, swelling, or redness in one or both heels, tenderness and tightness in the back of the heel that feels worse when the area is squeezed. Heel pain that gets worse after running or jumping, and feels better after rest. The pain may be especially bad at the beginning of a sports season or when wearing hard, stiff shoes like soccer cleats. Trouble walking. Walking or running with a limp or on tip toes.

Diagnosis

Physical examination varies depending on the severity and length of involvement. Bilateral involvement is present in approximately 60% of cases. Most patients experience pain with deep palpation at the Achilles insertion and pain when performing active toe raises. Forced dorsiflexion of the ankle also proves uncomfortable and is relieved with passive equinus positioning. Swelling may be present but usually is mild. In long-standing cases, the child may have calcaneal enlargement.

Non Surgical Treatment

To help relieve pain, give your child nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen, as directed by your child?s provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen and naproxen, may cause stomach bleeding and other problems. Read the label and take as directed. Unless recommended by your healthcare provider, your child should not take the medicine for more than 10 days. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome. Ask your child?s healthcare provider, How and when you will hear your child?s test results. How long it will take for your child to recover. What activities your child should avoid and when your child can return to normal activities. How to take care of your child at home. What symptoms or problems you should watch for and what to do if your child has them. Make sure you know when your child should come back for a checkup.

Prevention

As with all overuse injuries, it is important to warm up sufficiently before you exercise and warm down afterwards. You should build up any alterations in the intensity of your training gradually, and never continue exercising with weakened or fatigued muscles. Replace any worn or tattered shoes, as in this condition they become useless for absorbing shock and protecting the feet.

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