Does Severs Disease Often Need Surgery?

posted on 16 May 2015 04:24 by abashednosh651
Overview

Sever's disease is the most common cause of heel pain in the growing child. It is due to overuse and repetitive stress of the Achilles tendon where it attaches to the heel bone.

Causes

The actual pathology of the condition is one of more of an overuse syndrome in which the growth plate of the heel may become slightly displaced, causing pain. Biopsies of similar conditions have shown changes consistent with separation of the cartilage. The cause of Sever's disease is not entirely clear. It is most likely due to overuse or repeated minor trauma that happens in a lot of sporting activities - the cartilage join between the two parts of the bone can not take all the shear stress of the activities. Some children seem to be just more prone to it for an unknown reason, combine this with sport, especially if its on a hard surface and the risk of getting it increases. A pronated foot and tight calf muscles are common contributing factors. The condition is very similar to Osgood-Schlatters Disease which occurs at the knee.

Symptoms

The pain is at the heel or around the Achilles tendon. This is felt commonly during exercise, particularly activities involving running or jumping. The back of the heel may also be tender to touch and there may be localised swelling. There may be stiffness in the calf muscles first thing in the morning and you may notice limping or a tendency to tiptoe.

Diagnosis

Sever?s disease can be diagnosed based on the symptoms your child has. Your child?s doctor will conduct a physical examination by squeezing different parts of your child?s foot to see if they cause any pain. An X-ray may be used to rule out other problems, such as a broken bone or fracture.

Non Surgical Treatment

Depending on the diagnosis and the severity of the pain, there a number of treatment options available. Rest, reduce activity, your child should reduce or stop any activity that causes pain, such as sports and running. This can be a difficult option, as children are normally quite willful in pursuit of their favorite pastimes. Over the counter anti-inflammatory drugs, such as ibuprofen (found in Nurofen), to help reduce pain and inflammation. Make certain your child does stretching exercises before play. This will often help reduce the stress on the fascia and relieve heel pain in your child. Orthotic insoles. Orthotics made for children will help support the foot properly, and help prevent over-pronation or improper gait by supporting your child?s foot into a proper biomechanical position. Do not hesitate to schedule an appointment with a podiatrist, should your child?s heel and foot pain persist.

Exercise

Stretching exercises can help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should do these stretches 2 or 3 times a day. Each stretch should be held for about 20 seconds. Both legs should be stretched, even if the pain is only in 1 heel. Your child also needs to do exercises to strengthen the muscles on the front of the shin. To do this, your child should sit on the floor, keeping his or her hurt leg straight. One end of a bungee cord or piece of rubber tubing is hooked around a table leg. The other end is hitched around the child's toes. The child then scoots back just far enough to stretch the cord. Next, the child slowly bends the foot toward his or her body. When the child cannot bend the foot any closer, he or she slowly points the foot in the opposite direction (toward the table). This exercise (15 repetitions of "foot curling") should be done about 3 times. The child should do this exercise routine a few times daily.