Can I Deal With Calcaneal Apophysitis From Home?

Overview


Sever's disease or Calcaneal apophysitis is a condition that affects children between the ages of 10 and 13 years. It is characterized by pain in one or both heels with walking. During this phase of life, growth of the bone is taking place at a faster rate than the tendons. Hence there is a relative shortening of the heel-cord compared to the leg bones. As a result, the tension the heel-cord applies to the heel bone at its insertion is very great. Moreover, the heel cord is attached to a portion of the calcaneus (heel bone) that is still immature, consisting of a mixture of bone and growing cartilage, called the calcaneal apophysis, which is prone to injury. Compounding to this is the fact that all these changes are happening in a very active child, prone to overuse. The end result is therefore an overuse syndrome of injury and inflammation at the heel where the heel cord (Achilles Tendonitis) inserts into the heel bone (Calcaneal apophysitis).


Causes


There are several factors which may increase the likelihood of developing this condition. These need to be assessed and corrected with direction from a physiotherapist to ensure an optimal outcome. Some of these factors include inappropriate footwear, calf tightness and/or weakness, joint stiffness (particularly the foot and ankle), poor lower limb biomechanics, inappropriate or excessive training, inadequate recovery periods from training or activity, inappropriate training surfaces, inadequate warm up, poor core stability, a lack of lower limb strength and stability, poor proprioception or balance, rapid growth and age.


Symptoms


This is a condition that affects the cartilage growth plate and the separate island of growing bone on the back of the heel bone. This growth plate is called the physeal plate. The island of growing bone is called the apophysis. It has the insertion attachment of the Achilles tendon, and the attachment of the plantar fascia. This island of bone is under traction from both of these soft tissue tendon and tendon-like attachments.


Diagnosis


A Podiatrist can easily evaluate your child?s foot, lower limbs and muscular flexibility, to identify if a problem exists. If a problem is identified, a simple treatment plan is put in place. Initial treatment may involve using temporary padding and strapping to control motion or to cushion the painful area and based on the success of this treatment, a long-term treatment plan will be put in place. This long-term treatment plan may or may not involve Foot Supports, Heel Raises, muscle stretching and or strengthening.


Non Surgical Treatment


Stretching programs. Strengthening exercises. Exercise and training modification. Orthotic therapy. In rare cases, where fragmentation of the apophysis exists and pain fails to subside with traditional treatments then immobilization of the foot and ankle with a short leg pneumatic walker(walking cast) is indicated.


Exercise


For children with Sever's disease, it is important to habitually perform exercises to stretch the hamstrings, calf muscles, and the tendons on the back of the leg. Stretching should be performed 2-3 times a day. Each stretch should be performed for 20 seconds, and both legs should be stretched, even if the pain is only in one heel. Heel cups or an inner shoe heel lifts are often recommended for patient suffering from Sever's disease. Wearing running shoes with built in heel cups can also decrease the symptoms because they can help soften the impact on the heel when walking, running, or standing.

Tag : Severs Disease,Calcaneal Apophysitis