Does Calcaneal Apophysitis Have To Have Surgery Treatment?

Overview

Severs Disease, otherwise known as Osteochondroses, is the most common injury of its kind to affect children?s feet. The condition predominately affects children between the ages of 8 – 15 and causes pain at the back of the heel where the Achilles tendon inserts onto the bone. Children will complain of pain during activity and may have difficulty walking.

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 Achilles 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

Athletes with Sever?s disease are typically aged 9 to 13 years and participate in running or jumping sports such as soccer, football, basketball, baseball, and gymnastics. The typical complaint is heel pain that develops slowly and occurs with activity. The pain is usually described like a bruise. There is rarely swelling or visible bruising. The pain is usually worse with running in cleats or shoes that have limited heel lift, cushion, and arch support. The pain usually goes away with rest and rarely occurs with low-impact sports such as bicycling, skating, or swimming.

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

If your child is diagnosed with Sever’s disease, treatment is fairly straightforward. He or she should avoid any activities that cause a flare-up of heel pain. Treat the pain with ice for 20 minutes, three times a day. If the pain is severe, over-the-counter pain relievers such as acetaminophen or ibuprofen can be used for a short period of time. (Don’t use aspirin in a child or teen because it can result in a rare but life-threatening condition called Reye’s syndrome.) In some instances, a child might have other foot problems, as well, such as high arches, flat feet, or bowed legs. In these instances, your doctor can recommend an orthotic device to help further prevent the pain related to Sever’s disease. One other simple tip that can prevent Sever’s disease or speed along recovery is for your child to wear supportive shoes and avoid going barefoot as much as possible.

Prevention

The chances of a child developing heel pain can be reduced by avoiding obesity. Choosing well-constructed, supportive shoes that are appropriate for the child?s activity. Avoiding or limiting wearing of cleated athletic shoes. Avoiding activity beyond a child?s ability.

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