What Causes Severs Disease?

Submitted by kristanhildebrant231 on Fri, 09/22/2017 - 09:36.

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
During the growth spurt of early puberty, the heel bone (also called the calcaneus) sometimes grows faster than the leg muscles and tendons. This can cause the muscles and tendons to become very tight and overstretched, making the heel less flexible and putting pressure on the growth plate. The Achilles tendon (also called the heel cord) is the strongest tendon that attaches to the growth plate in the heel. Over time, repeated stress (force or pressure) on the already tight How long does Achilles tendonitis last for? tendon damages the growth plate, causing the swelling, tenderness, and pain of Sever's disease. Such stress commonly results from physical activities and sports that involve running and jumping, especially those that take place on hard surfaces, such as track, basketball, soccer, and gymnastics.

Symptoms
Signs and symptoms of Sever?s disease include heel pain can be in one or both heels, and it can come and go over time. Many children walk or run with a limp, they may walk on their toes to avoid pressure on their heels. Heel pain may increase with running or jumping, wearing stiff, hard shoes (ex. soccer cleats, flip-flops) or walking barefoot. The pain may begin after increasing physical activity, such as trying a new sport or starting a new sports season.

Diagnosis
In Sever's disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or she runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that your child's heel tendons have become tight.

Non Surgical Treatment
Your physiotherapist will guide you and utilise a range of pain relieving techniques including joint mobilisations for stiff ankle or subtalar joints, massage or electrotherapy to assist you during this pain-full phase. Your physiotherapist will identify stiff joints within your foot and ankle complex that they will need to loosen to help you avoid overstress. A sign that you may have a stiff ankle joint can be a limited range of ankle bend during a squat manoeuvre. Your physiotherapist will guide you. Your foot arch is dynamically controlled via important foot arch muscles, which be weak or have poor endurance. These foot muscles have a vital role as the main dynamically stable base for your foot and prevent excessive loading through your plantar fascia. Any deficiencies will be an important component of your rehabilitation. Your physiotherapist is an expert in the assessment and correction of your dynamic foot control. They will be able to help you to correct your normal foot biomechanics and provide you with foot stabilisation exercises if necessary.

Prevention
To prevent recurrence, patients, parents, coaches, and trainers should be instructed regarding a good preexercise stretching program for the child. Early in the season, encouragement should be given for a preseason conditioning and stretching program. Coaches and trainers should be educated about recognition of the clinical symptoms so they are able to initiate early protective measures and seek medical referral when necessary.