Sever's Disease

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Original Editors

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Search Strategy

To collect some information about this topic, I searched the Web of Knowledge database, the PeDro database and the Pubmed database. The main keywords I used were: Sever’s Disease, Calcaneal Apophysitis, physiotherapy, physical therapy, diagnosis, treatment, rehabilitation (often a combination of keywords). I also consulted books for my research (resources).
Most successful keywords: Sever’s Disease; Calcaneal Apophysitis; treatment; physical therapy.
Keyword combinations: Sever’s Disease treatment ; Calcaneal Apophysitis treatment; physical therapy calcaneal apophysitis.

Definition/Description

Sever’s disease, also known as calcaneal apophysitis or Osgood-Schlatter syndrome of the foot. This traction apophysitis is secondary to repetitive microtraumata or overuse of the heel in young athletes. [1]

Clinically Relevant Anatomy

The calcaneus is situated at the most plantar posterior aspect of the foot. The Achilles tendon inserts to the lower, posterior and slightly medial aspect of the calcaneus. The plantar fascia originates from the medial tubercle on the plantar aspect of the calcaneus. Proximal to the epiphysis is the apophysis, where the Achilles tendon actually inserts. The calcaneal growth plate and apophysis are situated in an area subject to high stress from the plantar and Achilles tendon. [2]

File:Voet apophyse.png

[2]

Epidemiology /Etiology

Sever’s disease is an osteochondrosis caused by overloading the insertion of the Achilles tendon onto the calcaneus and the apophyseal growth plate in this area. This C-shaped growth zone can become inflamed secondary to repetitive traction stress of the Achilles tendon. Calcaneal apophysitis is a common injury in young athletes and is believed to be caused by running and jumping.
Active Children and adolescents (usual age of occurrence: 7 to 15 years), particularly during the pubertal growth spurt or at the beginning of a sport season (e.g. gymnasts, basketball and football players, …), often suffer from this condition. This disease occurs most commonly during the early part of the growth spurt. A boy-to-girl ratio is 2-3:1.
None of these causative factors has been tested prospectively and, where tested, none of the measurements has been carried out systematically, and reliability or validity of the measurements
has not been considered. [2]

Characteristics/Clinical Presentation

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Differential Diagnosis

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Diagnostic Procedures

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Outcome Measures

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Examination

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Medical Management

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Physical Therapy Management

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Key Research

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Resources

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Clinical Bottom Line

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Recent Related Research (from Pubmed)

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References

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