Overview
One of the most important things to know about Sever's disease is that, with proper care, the condition usually goes away within 2 weeks to 2 months and does not cause any problems later in life. Most children can return to physical activity without any trouble once the pain and other symptoms go away. 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.
Causes
There are usually two root causes of Sever?s disease that we?ve found that effect young athletes. Arches are not supported causing a dysfunctional run, jump, and landing. The calves (gastrocnemius and soleus muscles) are overworked, tight, and do not allow proper movement of foot which puts extreme pressure on the Achilles? tendon, in turn irritating the growth plate in the heel.
Symptoms
This syndrome can occur unilaterally or bilaterally. The incidence of bilaterally is approximately 60%. Common signs and symptoms include posterior inferior heel pain (over the medial and lateral surface of the bone). Pain is usually absent when the child gets up in the morning. Increased pain with weight bearing, running or jumping (= activity-related pain). The area often feels stiff. The child may limp at the end of physical activity. Tenderness at the insertion of the tendons (= an avascular necrosis of the arthropathy). Limited ankle dorsiflexion range secondary to tightness of the Achilles tendon. Hard surfaces and poor-quality or worn-out athletic shoes contribute to increased symptoms. The pain gradually resolves with rest. Reliability or validity of methods used to obtain the ankle joint dorsiflexion or biomechanical malalignment data are not commented upon, thus reducing the quality of the data. Although pain and limping are mentioned as symptomatic traits, there have been no attempts to quantify the pain or its effect on the individual.
Diagnosis
Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.
Non Surgical Treatment
Although most cases do get better on their own, recovery typically takes several weeks or months. Adolescents can continue to play sports if the activity does not cause discomfort, but staying active does prolong the recovery period without treatment. As a result, rest and avoidance of athletic activity is usually recommended, along with medication for pain and swelling.
Prevention
Treat symptoms when they occur with RICE and NO HARM. RICE (Rest Ice, Compression and Elevation) will help following activity and when symptoms flare, while No HARM (No Heat, alcohol, running or massage) will help reduce the symptoms from occurring. Orthotics. The use of an Interpod Orthotic will assist in realigning the foot, which will reduce the stress on the Achilles Tendon and prevent reoccurring symptoms. The orthotic achieves this by reducing the forces and stress placed on the limbs during walking and running. Exercise reduction. Patients may need to reduce their level of activity if this is seen as a contributing factor. Training errors. Ensue athletes warm up and cool down correctly with stretching activities. Footwear. Sporting and school shoes should have an appropriate heel height to assist in offloading of the Achilles tendon.
One of the most important things to know about Sever's disease is that, with proper care, the condition usually goes away within 2 weeks to 2 months and does not cause any problems later in life. Most children can return to physical activity without any trouble once the pain and other symptoms go away. 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.
Causes
There are usually two root causes of Sever?s disease that we?ve found that effect young athletes. Arches are not supported causing a dysfunctional run, jump, and landing. The calves (gastrocnemius and soleus muscles) are overworked, tight, and do not allow proper movement of foot which puts extreme pressure on the Achilles? tendon, in turn irritating the growth plate in the heel.
Symptoms
This syndrome can occur unilaterally or bilaterally. The incidence of bilaterally is approximately 60%. Common signs and symptoms include posterior inferior heel pain (over the medial and lateral surface of the bone). Pain is usually absent when the child gets up in the morning. Increased pain with weight bearing, running or jumping (= activity-related pain). The area often feels stiff. The child may limp at the end of physical activity. Tenderness at the insertion of the tendons (= an avascular necrosis of the arthropathy). Limited ankle dorsiflexion range secondary to tightness of the Achilles tendon. Hard surfaces and poor-quality or worn-out athletic shoes contribute to increased symptoms. The pain gradually resolves with rest. Reliability or validity of methods used to obtain the ankle joint dorsiflexion or biomechanical malalignment data are not commented upon, thus reducing the quality of the data. Although pain and limping are mentioned as symptomatic traits, there have been no attempts to quantify the pain or its effect on the individual.
Diagnosis
Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.
Non Surgical Treatment
Although most cases do get better on their own, recovery typically takes several weeks or months. Adolescents can continue to play sports if the activity does not cause discomfort, but staying active does prolong the recovery period without treatment. As a result, rest and avoidance of athletic activity is usually recommended, along with medication for pain and swelling.
Prevention
Treat symptoms when they occur with RICE and NO HARM. RICE (Rest Ice, Compression and Elevation) will help following activity and when symptoms flare, while No HARM (No Heat, alcohol, running or massage) will help reduce the symptoms from occurring. Orthotics. The use of an Interpod Orthotic will assist in realigning the foot, which will reduce the stress on the Achilles Tendon and prevent reoccurring symptoms. The orthotic achieves this by reducing the forces and stress placed on the limbs during walking and running. Exercise reduction. Patients may need to reduce their level of activity if this is seen as a contributing factor. Training errors. Ensue athletes warm up and cool down correctly with stretching activities. Footwear. Sporting and school shoes should have an appropriate heel height to assist in offloading of the Achilles tendon.