What Is Calcaneal Apophysitis?

posted on 17 May 2015 06:32 by unaccountablefi95
Overview

Another name for Sever?s Disease is calcaneal apophysitis. The heel bone is called the calcaneus. Sever?s Disease is heel pain thought to be caused by inflammation around the growth plate in the calcaneus (apophysis). It is most likely due to repetitive overuse during sports and exercise, which causes increased strain on the heel growth plate. Sever?s Disease won?t cause long-term damage or arthritis. Sever?s Disease is often associated with tight heel tendons. It most commonly affects physically active children who are between the ages of 8, 14 years old, such as soccer players and gymnasts.

Causes

Contraction of the calf muscles along with the rapid growth of the leg bone (tibia), decreases ankle motion and increases strain on the heel area. This puts strain on the Achilles tendon. Injury results from repetitive pulling through the heel bone by the Achilles and the traction forces from the plantar fascia.

Symptoms

Symptoms include heel pain related to sports activities and worsen after those sport and exercise activities. However, some children who are not in a sport may also get this if they are physically active. If you notice that your child is ?walking on their toes? this is a sign of possible heel pain. The pain is usually on the back of the heel, the sides of the heel, the bottom of the heel, or a combination of all of these. We typically don't see swelling with this, however if pressure is applied to the sides of the heel pain may be reported. Sometimes the pain is so bad the child will have to limp, or take a break from sports activity either for a few days or few months.

Diagnosis

Sever?s disease can be diagnosed based on your history and symptoms. Clinically, your physiotherapist will perform a "squeeze test" and some other tests to confirm the diagnosis. Some children suffer Sever?s disease even though they do less exercise than other. This indicates that it is not just training volume that is at play. Foot and leg biomechanics are a predisposing factor. The main factors thought to predispose a child to Sever?s disease include decrease ankle dorsiflexion, abnormal hind foot motion eg overpronation or supination, tight calf muscles, excessive weight-bearing activities eg running.

Non Surgical Treatment

Fortunately Severs? disease can be treated and prevented through a number of different techniques that have all proven highly effective. The heel will repair itself even without active treatment provided that the suffering foot is given a chance to heal. Typically Severs? disease will take 2-8 weeks, although in many cases it can take longer as the continuous growing of the bone can exacerbate the condition. Podiatrists have an important role in preventing Severs? disease in young athletes, and in treating the condition when it develops so children can get back on their feet as quickly as possible. Generally treatment involves stretching muscles running down to the heel to relieve tension and pain, these include the hamstrings and calf muscles, and these stretching exercises will need to be performed at least 2 or 3 times a day. RICE is a classic method of speeding up the recovery of self-healing injuries like Severs? disease. This involves Rest, the application of Ice to the injury, Compression, and finally Elevation to encourage repaid. These measures can be advised by a trained podiatrist, but it is then up to a child to carry on with regular RICE.