Sever's disease
| Severs | |
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| Classification and external resources | |
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File:Gray1241.png The mucous sheaths of the tendons around the heel. Lateral aspect. (Tendo calcaneus labeled at left.) | |
| DiseasesDB | 11980 |
| eMedicine | orthoped/622 |
Sever's disease or calcaneal apophysitis, is the most common cause of heel pain in the growing athlete and is due to overuse and repetitive microtrauma of growth plates of the calcaneus in the heel. It occurs in children ages 7 to 15, with the majority of patients presenting between 10 and 12 years of age. It is in relation to Osgood-Schlatter disease which affects the knee rather than the heel/ankle.
Contents
Eponym
It is named for JW Sever, who characterized it in 1912.[1]
Symptoms
- Complaints of pain or tenderness in the heel (or heels)
- Discomfort upon awaking, or when heel is squeezed
- Limping
- More severe pain after walking or exercise, and increased difficulty walking
- Pain during running or playing a sport
Cause
Sever’s disease is directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves lots of heel movements. It can be associated with starting a new sport, or the start of a new season.[2] Too much weight bearing down on the heel can also cause it as can excessive traction since the bones and tendons are still developing. It occurs more commonly in children who pronate, and involves both heels in more than half of patients.
Treatment
Treatment may consist of one or more of the following:
- Elevating the heel
- Stretching hamstring and calf muscles 2-3 times daily
- Using R.I.C.E. (Rest, Ice, Compression, Elevation)[3]
- Foot orthotics
- Medication
Recovery
Sever’s disease is self-recovering, meaning that it will go away on its own when it is used less or when the bone is through growing. The condition is not expected to create any long-term disability, and expected to subside in 2–8 weeks.[3]
However, while the disease does subside quickly, it can recur, for example at the start of a new sports season. The only known cure is for children to outgrow the condition, and recurrences happen for an average of 18 months before this occurs.
It is more common in boys, although occurs in girls as well. The average age of symptom obset is 9-11.
Prevention
- Maintain good flexibility through stretching exercises
- Avoid excessive running on hard surfaces
- Use quality, well-fitting shoes with firm support and a shock-absorbent sole
See also
References
- ↑ Sever JW: Apophysitis of the Os Calcis. New York Medical Journal 1912; 95: 1025-1029.
- ↑ Hendrix CL (2005). "Calcaneal apophysitis (Sever disease)". Clinics in podiatric medicine and surgery. 22 (1): 55–62, vi. doi:10.1016/j.cpm.2004.08.011. PMID 15555843.
- ↑ 3.0 3.1 Madden CC, Mellion MB (1996). "Sever's disease and other causes of heel pain in adolescents". American family physician. 54 (6): 1995–2000. PMID 8900359.
Micheli and Ireland. Prevention and Management of Calcaneal Apophysitis in Children: An Overuse Syndrome. Journal of Pediatric Orthopedics 1987; 7(1): 34-38.
http://www.footphysicians.com/footankleinfo/pediatric-heel-pain.htm
External links
- Bibliography: http://www.epodiatry.com/heel-pain-children.htm
- http://familydoctor.org/158.xml
- http://www.footphysicians.com/footankleinfo/pediatric-heel-pain.htm
