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May 21 2015

utterelection6411

Physical Rehabilitation And Severs Disease

Overview

Sever's disease is a disorder that commonly occurs in active children between the ages of 9 and 13 years of age. Even though it is misnamed as a disease, it is actually a self-limiting disorder that occurs around the growth plate in the back of the heel. The Achilles tendon attaches to the upper portion of the heel growth plate. On the bottom of the growth plate is an attachment of a ligament known as the plantar fascia. With increased activity, there is a pulling or tugging that occurs on this growth plate, and a portion of the growth plate is being pulled away from its attachment to the heel. X-rays are often taken to verify the position and location of this growth plate.

Causes

During the growth spurt of early puberty, the bones often grow faster than the leg muscles and tendons. This can cause the muscles to become very tight and overstretched, the heel becomes less flexible and this build-up of pressure can result in redness, swelling, tenderness and pain at the heel.

Symptoms

Acute pain, pain asscoiatied with Sever?s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running. Highly active - children who are very active are among the most susceptible in experiencing Sever?s disease, because of the stress and tension placed on their feet.

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

The treatment of Sever's disease should be individualized. The most important first steps in the treatment of Sever's disease are activity modification (including rest and sometimes crutches) and good shoes. Further treatment may include icing to decrease pain around the calcaneal apophysis, stretching and strengthening exercises, shoe orthotics or medications to relieve pain. Rarely, a removable cast is necessary to completely rest the foot.

Prevention

As with all overuse injuries, it is important to warm up sufficiently before you exercise and warm down afterwards. You should build up any alterations in the intensity of your training gradually, and never continue exercising with weakened or fatigued muscles. Replace any worn or tattered shoes, as in this condition they become useless for absorbing shock and protecting the feet.

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Schweinderl