severs
Table of Contents
Sever's disease
introduction
- a cause of heel pain in pubertal adolescents which is exacerbated by running and jumping activities, first described by J.W. Sever in 1912 1)
- most commonly affects boys aged 12 to 14 years and girls aged 10 to 12 years
- usually subsides by the age of 17 if chronic symptoms appear and does not cause long term problems.
differential diagnosis
- plantar fasciitis:
- inflammation of the ligament that runs from the heel bone along the sole of the foot.
- causes include flat feet and stiff shoes
- bursitis:
- common causes of bursitis at the back of the heel include injury, overuse and tight shoes.
-
- the Achilles tendon attaches the calf muscle to the heel. Inflammation of this tendon can be caused by stiff calf muscles and running on hard surfaces like concrete or bitumen.
- stress fracture
- a hard impact or awkward landing may fracture the heel bone
diagnosis
- largely clinical supported by plain Xray
- plain Xray shows increased density and/or fragmentation of the Achilles apophysis on the posterior aspect of the calcaneum.
Mx
- rest, ice
- flexibility exercises to help lengthen the lower leg muscles
- shoe inserts may help
- non-weight bearing exercises such as swimming and cycling once initial symptoms settle
- analgesics
- time - it may take 2-8 weeks for the symptoms to settle with avoidance of running and jumping.
1)
Sever JW: Apophysitis of the Os Calcis. New York Medical Journal 1912; 95: 1025-1029.
severs.txt · Last modified: 2009/09/10 07:26 by 127.0.0.1