Physical Therapy And Calcaneal Apophysitis

Overview

This is a condition that is quite often misdiagnosed as growing pains this generally affects boys more than it may affects girls, especially between the ages of 9 and 15. This is a common disease in children that play the following sports. Soccer. Football. Basketball. Hockey. However it is not limited just to these sports, nor is it simply a pre-season type condition related to fitness. Sever?s Disease is common and although it does not sound good there is no need to panic as it is not something you can catch or incurable. Children have a growth plate in the heel bone, which at puberty becomes solid and forms part of the heel, prior to puberty this can cause pain especially if the child?s foot rolls inwards or outwards too much, this can cause increased stress on this growth plate and therefore causes pain.

Causes

The heel bone grows faster than the ligaments in the leg. As a result, muscles and tendons can become very tight and overstretched in children who are going through growth spurts. The heel is especially susceptible to injury since the foot is one of the first parts of the body to grow to full size and the heel area is not very flexible. Sever?s disease occurs as a result of repetitive stress on the Achilles tendon. Over time, this constant pressure on the already tight heel cord can damage the growth plate, causing pain and inflammation. Such stress and pressure can result from, Sports that involve running and jumping on hard surfaces (track, basketball and gymnastics). Standing too long, which puts constant pressure on the heel. Poor-fitting shoes that don?t provide enough support or padding for the feet. Overuse or exercising too much can also cause Sever?s disease.

Symptoms

Children aged between 8 to 13 years of age can experience Sever?s disease with girls being normally younger and boys slightly older. Sever?s disease normally involves the back of the heel bone becoming painful towards the end of intense or prolonged activity and can remain painful after the activity for a few hours. Severe cases can result in limping and pain that can even remain the next morning after sport.

Diagnosis

All medical diagnosis should be made by taking a full history, examining the patient then performing investigations. The problem usually occurs in boys who are going through or have just gone through a growth spurt; one or both heels may be affected. Initially the pain may be intermittent occurring only during or after exercise. As the problem gets worse, pain may be present most of the time. There may be swelling over the back of the heel and this area is painful if touched or knocked. On examination the patient often has flat feet, very tight legs muscles especially the gastrocnemius.

Non Surgical Treatment

Sever disease is heel pain in children. This pain is caused by inflammation of the heel growth plate. The growth plate is the area where the bone grows. It is located on the lower back part of the heel.

Prevention

Sever's disease may be prevented by maintaining good joint and muscle flexibility in the years leading up to, and during, their growth spurts (eg girls 8 to 10, boys 10 to 12). Foot arch problems such as flat feet should be addressed after the age of five if they don't appear to be self-correcting. If you are concerned, please ask your health practitioner. The most important factor is the amount of weight-bearing exercise your child is currently performing. Finally, LISTEN To Your Child! If your child is suffering heel pain between the ages of 8 to 12, suspect Sever's disease until proven otherwise. Seek the professional opinion of your foot practitioner regarding its diagnosis and subsequent management.

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