Coping With Calcaneal Apophysitis

posted on 21 May 2015 04:53 by abjectvolition75
Overview

Sever?s disease is a heel problem that is the most common cause of heel pain that commonly occurs in children. It is caused by repetitive use and overuse of the heel while it is still growing, therefore is more common in active children and teenagers. Despite the name, Sever?s Disease like Osgood- Schlatter disease is caused by overuse and is not a disease.

Causes

The most common of the Sever?s disease causes is when the heel bone grows more rapidly than the muscles and tendons in the leg. The muscles and tendons become tight and put additional stress on the growth plate in the heel. When this happens, the growth plate begins to swell, becomes tender, and the child will essentially begin to feel one or more Sever?s disease symptoms. It can occur in any child as they grow, but there are some common Sever?s disease causes and risk factors that make a child more prone to the condition. They include participation in sports and other activities that put pressure on the heel, such as basketball, track, and gymnastics. A pronated foot, which makes the Achilles tendon tight, increasing the strain on the growth plate of the heel. An arch that is flat or high, affecting the angle of the heel. Short leg syndrome, when one leg is shorter than the other, causing the shorter leg to pull more on the Achilles tendon in order to reach the ground. Obesity puts extra weight on the growth plate, which can cause it to swell.

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

Your Podiatrist or Physiotherapist will assist in diagnosing the injury and the extent of the damage. From this, they will develop a management plan which may include rest or activity modification, soft tissue treatment such as massage and stretching, correction of biomechanics through heel raises or orthoses and the progression through a series of specific strengthening exercises.

Non Surgical Treatment

Initially, treatment will consist of resting from activity, ice and anti-inflammatory medications to reduce the pain. Your physiotherapist may also use a variety of pain reducing techniques such as soft tissue massage or joint mobilisations. They may recommend taping to unload the area of pain, heel cups or wedge inserts into the bottom of your shoe. Also in the initial phase we may also refer you to podiatry for orthotics and/or further footwear recommendations. It is also ideal in the first instance to start stretching your calf muscles and achilles. This initial phase typically lasts for 1-2 weeks. During this time your physiotherapist will guide you on appropriate levels of activity- they may recommend you rest from impact type activities during this phase, and will guide you on the best program to return to your sport without any further injury.

Prevention

Can Calcaneal Apophysitis Be Prevented? The chances of a child developing heel pain can be reduced by avoiding obesity. Choosing well-constructed, supportive shoes that are appropriate for the child?s activity. Avoiding or limiting wearing of cleated athletic shoes. Avoiding activity beyond a child?s ability.