Sever's disease responses

Sever's disease responses

Many thanks to all who responded. Below is my original post followed by the
responses.

William Earles, CO
Beacon Prosthetics and Orthotics
Raleigh, NC 27610

I am scheduled to see a nine year old patient with the diagnosis of Sever's
disease or Osteochondrosis. I am not familiar with this diagnosis or its
treatment and was hoping to get some advice on the most effective orthotic
treatment for this condition.

Responses:

In most cases it refers to calcaneal epiphysitis if
this is the case immobilization of the foot and heel
is the treatment required such as a solid ankle AFO
this is to releve stress on the caneus at the
epiphysis hope this is helpful Chris Plunk RTPO
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Sever,s disease is osteochondrosis of the calcaneus. In some kids it can be
very debilitating due to heel pain. I have been using a UCB with good
success for a number of years. Sometimes I'll add a PPT pad to the plantar
aspect of the heel (inside the ucb) for some further pain relief.

John Wall PT,CPO, FAAOP
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i like to no were is the mose affected it is the lower lamp or wat
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Osteochondrosis----Inflammation of both bone and its cartilage.

<URL Redacted>

Good Luck,

Chuck
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I believe it has to do with the growth plate at the heel, very painful.
Usually use ucb with good calc. molding. Hope this helps.
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Hello,
I'm a resident at Connecticut Children's Medical
Center, and I've encountered close to 5 patients w/
Sever's disorder or disease in the past year. We work
closely with Orthopedics in the hospital, and from
what I understand, Sever's is like Osgood Slaughter's
(sp?) except at the insertion of the achilles tendon.
many of the patients present w/ localized pain at the
medial posterior heel. I also heard from one of the
doctors that Sever's is a catch- all diagnosis for
foot pain. If it is actually Sever's, it's something
that's outgrown. The doctors here prescribe gel heel
cups (Silipos), or plastic heel cups, depending on the
doctor. I read in the Atlas of Orthotics, I believe,
that elevating the heel with a lift takes some of the
stress off the point of insertion. I've found this to
be the best bet. Hope this helps, Zach
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As I recall, Severs is a pulling away of the tendo-achillies insertion on the
calcaneous. I had a teenage male pt. that complained of symptoms only when he
was hiking uphill, not down. I made insoles with heel wedges on the order of
1/2 to 5/8 thick for him. This effectively lessened the dorsiflexion angle
of his tibia relative to his foot, but not his tibia relative to the ground.

If you cant get enough relief with insoles, consider wedging the heel of the
shoe. If the pt. is female (unlikely) then she can simply wear high heeled
shoes.

I'd like to see any other responses--please post a compilation.

Good Luck, Troy Fink, CO
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It's no big deal it is self limiting and caused by over doing it ie. running
in sports. You can put in a small removable lift in the heel of the shoes .If
it hurts don't do it.

     Rick Chavez CPO
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We treat with just a heel wedge in the shoe. This takes some of the stress
off of the insertion of the heel cord into the calcaneus. It is a self
limiting irritation of the insertion, that usually resolves spontaneously.
Jim Athearn, CO
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William,
Severs disease is the calcaneal equivalent of Osgood Schlatters. The
epiphyseal-TA insertion is inflamed. no athletic activity and hel elevation
allows healing.

Regards,
John.
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If you go to www.medmedia.com it will access you to the Wheeles textbook of
Orthopedics which is a great reference to orthopedic conditions. It's a
seperation of the calcaneal aphophysitis. Generally, it's treated
with a heel lift.

Nadine
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Try something simple first, like heel raises, Put as much as you can into the
shoe initially and slowly remove height as symptoms reside. Also limit their
sporting activity, particularly high impact ones for a period. Most
apophysitis
- insertional tractional type overuse injuries respond quite well with simple
Tx's. NSAIDS may also reduce acute symptoms.
Cheers
Ben
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