Calcaneal Apohystis Essay

1017 Words May 1st, 2013 5 Pages
An update on Calcaneal Apophysitis (Sever’s disease)

Often children between the ages of eight and thirteen attend the podiatry clinic with heel pain. One differential diagnosis is calcaneal apophysitis or otherwise known as sever’s disease. Calcaneal apophysitis is the inflammation of a calcaneal growth plate causing pain in the heel posteriorly, it is classified as a non-articular Osteochondrosis at an impact site (O’Gradaigh & Crisp, 2012).

The calcaneus in a child under sixteen years contains a growth plate posteriorly. This is the section where the Achilles tendon inserts on the calcaneus. Around sixteen years of age, the growth plate ossifies onto the calcaneum. Sever’s disease is the disturbance or micro trauma in
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Other treatments include encouraging the child to wear training shoes, utilising shock absorbing insoles, posterior muscle group stretching, physical modalities, patient education, heel pads, rearfoot medial wedges or heel cups. Non-steroidal anti-inflammatory drugs may be useful (Ogden et al, 2004), however it should not be utilised as a substitute to the cease of physical sporting activities and in severe cases immobilisation may be necessary. Sever’s disease is cured by the fusion of the epiphysis with the calcaneal bone (Kvist & Heinonem, 1991). Therefore patient and parent education on the condition is essential. Other allied health and alternative therapy modalities may be beneficial to provide a holistic management plan.

Once the pain has subsided due to limiting physical sporting activities, it is essential the sporting activities are undertaken gradually and built up to full activity over a reasonable period of time. While weight bearing exercise has ceased, cardiovascular fitness can still be maintained through non weight-bearing activities such as cycling and swimming. A long term management plan is unnecessary; when activity is reduced the condition usually subsides in less than three months. This is when the individual is able to return to sporting activities. There are no long term complications associated with calcaneal apophysitis.

Newer techniques, such as chondral resurfacing techniques, are expected to offer a better outlook for those who

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