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Anuncio de los artículos posteados en: Mayo 2015

20 Mayo 2015 
Overview


Sever's disease is a condition characterized by pain in one or both heels with walking. The pain is caused by shortening of the heel-cord. It usually affects children between the ages of 10 and 13 years old. During this phase of life, growth of the bone is taking place at a faster rate than the tendons. Sever's disease is also called calcaneal apophysitis.


Causes


There are several factors which may increase the likelihood of developing this condition. These need to be assessed and corrected with direction from a physiotherapist to ensure an optimal outcome. Some of these factors include inappropriate footwear, calf tightness and/or weakness, joint stiffness (particularly the foot and ankle), poor lower limb biomechanics, inappropriate or excessive training, inadequate recovery periods from training or activity, inappropriate training surfaces, inadequate warm up, poor core stability, a lack of lower limb strength and stability, poor proprioception or balance, rapid growth and age.


Symptoms


Severs causes swelling, pain and tenderness over the back of the heel. Your child may walk with a limp. Initially the pain may be intermittent occurring only during or after exercise. As the problem gets worse, pain may be present most of the time. The swelling increases and is painful when touched or knocked. It commonly affects boys who are having a growth spurt during their pre-teen or teenage years. One or both knees may be affected.


Diagnosis


Sever?s disease can be diagnosed based on your history and symptoms. Clinically, your physiotherapist will perform a "squeeze test" and some other tests to confirm the diagnosis. Some children suffer Sever?s disease even though they do less exercise than other. This indicates that it is not just training volume that is at play. Foot and leg biomechanics are a predisposing factor. The main factors thought to predispose a child to Sever?s disease include decrease ankle dorsiflexion, abnormal hind foot motion eg overpronation or supination, tight calf muscles, excessive weight-bearing activities eg running.


Non Surgical Treatment


See a doctor, who can diagnose the injury and recommend appropriate treatment options. It will be beneficial to rest the affected heel, and to regularly ice the affected area for the first few days. Anti-inflammatory pain medication can reduce pain and swelling, but first check with your doctor. As the pain diminishes a physical therapist can assist with a program of rehabilitation, incorporating stretching and strengthening exercises focused on the calf, shin and hamstring muscles. For a period after the injury has healed the doctor may advise on changes to your training routines that seek to lessen the strain on the heels. Orthotics are often recommended for your shoes in order to correct any biomechanical problems or lend extra support to the heels.


Prevention


It is important to undertake correct warm ups and warm downs before and after exercise. This should include a stretching routine. It may be necessary to undertake additional stretching outside of sport, especially during stages of growth. Only playing one sport should be avoided. You should not allow your child to play through pain.
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