Six Ways Podiatrists Can Assist Your Patients That May Surprise You.
Part 4: Sever’s Disease. Heel Pain in Children.
Sever’s Disease / Calcaneal Epiphysitis / Calcaneal Avascular Necrosis / Osteochondrosis
Sever’s disease is a childhood condition of the calcaneal growth plate. Peak incidence occurs between 10 to 14 years of age. It is more common in boys, athletes and particularly those involved in field sports such as soccer, football and cricket. Often it is particularly painful after finishing the game, upon standing after resting, and the first steps the next morning.
Sever’s disease is a mechanical condition caused by a poor foot position. In a perfectly functioning foot, when the heel strikes the ground, the growth plate that is sandwiched between the bony ends of the calcaneus is compressed evenly across the whole surface. With excessive pronation, the bone is compressed on an angle that causes a shearing stress on the plate. This causes it to become inflamed, painful and to swell within its very tight space.
As the vascular supply of the terminal segment of the calcaneus passes through the plate, a serious problem can arise if the increase in internal pressure obstructs blood flow. This can result in avascular necrosis – true Sever’s disease. – requiring a recovery period of up to two years Obviously, this is to be avoided as no active child wants to suffer pain nor be forced to sit out of sport for long periods.
Fortunately, avascular necrosis will almost always have a long lead up time. It is unlikely that bone will die without several months of increasing pain giving warning of what is to come. Treatment involves using orthotic devices, avoiding shoes that are very flat and ensuring that the calf muscles are diligently stretched both daily and before any activity. Treatment with the podiatrist is very likely to resolve the
problem within a matter of days.
If you would like to ask any questions or be provided with further reading on the topic, address your communication to Stephanie Cosgrove at [email protected] or to our clinical locations in Hamilton, Indooroopilly, Toombul or Bribie Island by using this Contact Us link.
Further patient-directed information can be found here: Patient Info Sheet.
Part 1: Trochanteric Bursitis – A simple cure
Part 2: Nocturnal Paraesthesia
Part 4: Sever’s Disease
Part 5: Patello-femoral Pain
Part 6: Do Podiatrists still do Chiropody ?