Sever's disease
| Severs | |
|---|---|
| Classification and external resources | |
 The mucous sheaths of the tendons around the heel. Lateral aspect. (Tendo calcaneus labeled at left.) |
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| ICD-9 | 732.5 |
| 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 14 years of age. It is in relation to Osgood-Schlatter disease which affects the knee rather than the heel/ankle.
Contents |
[edit] Eponym
It is named for JW Sever, who characterized it in 1912.[1]
[edit] 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, and/or walking
[edit] 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 a lot of heel movement. It can be associated with starting a new sport, or the start of a new season.[2] Too much weight bearing 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 over-pronate, and involves both heels in more than half of patients.
[edit] 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
- Physical Therapy
[edit] Recovery
Sever’s disease is self-recovering, meaning that it will go away on its own when the foot 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] The disease may also take several years to stop, because it is often triggered by growing too fast. It is more common in boys, although occurs in girls as well. The average age of symptom onset is 9–11.
[edit] 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
[edit] See also
[edit] References
- ^ Sever JW (1912). "Apophysitis of the Os Calcis". New York Medical Journal 95: 1025–9.
- ^ 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.
- ^ a b 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 LJ, Ireland ML (1987). "Prevention and management of calcaneal apophysitis in children: an overuse syndrome". J Pediatr Orthop 7 (1): 34–8. PMID 3793908.
- http://www.footphysicians.com/footankleinfo/pediatric-heel-pain.htm
[edit] External links
- Bibliography: http://www.epodiatry.com/heel-pain-children.htm
- http://familydoctor.org/158.xml
- http://www.footphysicians.com/Content.aspx?id=1483
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