Will A Heel Spur Hurt?
Overview
A heel spur is a bony projection at the base of the heel bone, as defined by the website webmd.com. Heel spurs are often accompanied by plantar fasciitis, the inflammation of the soft tissues surrounding the spur, and that is what causes the pain in those who suffer from this condition. To cure or remove a heel spur you will need to see a podiatrist; however, there are some natural remedies and exercises that may help.
Causes
There exists a membrane that covers most of the bone along the heel. When this membrane gets torn repeatedly due to straining of the muscles in the foot, the calcium deposits that lead to heel spurs are more likely to occur.
Symptoms
The following symptoms are typical of heel spur. Stabbing pain when treading on the area affected. Dull, irregularly occurring pains in the heel area also without exerting pressure (e.g. in a reclining position) Pain when taking the first steps in the morning (after lying or sitting down for an extended period, especially in the morning) Occasional swelling in the ankle area. For the lower heel spur, extreme sensitivity at the tendon attachment (laterally in the lower heel area) For the upper heel spur, extreme pressure sensitivity of the Achilles tendon, primarily at approximately ankle height.
Diagnosis
Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).
Non Surgical Treatment
Some heel spurs do require surgery, however surgery is a last resort. In most cases the patients underlying foot problem needs to be addressed, such as Over Pronation and Over Supination and Heel Pain Treatment Options need to be implemented if Plantar Fasciitis and Achilles Tendonitis are still an ongoing concern. Your best treatment is always prevention.
Surgical Treatment
Sometimes bone spurs can be surgically removed or an operation to loosen the fascia, called a plantar fascia release can be performed. This surgery is about 80 percent effective in the small group of individuals who do not have relief with conservative treatment, but symptoms may return if preventative measures (wearing proper footwear, shoe inserts, stretching, etc) are not maintained.
Prevention
There are heel spur prevention methods available in order to prevent the formation of a heel spur. First, proper footwear is imperative. Old shoes or those that do not fit properly fail to absorb pressure and provide the necessary support. Shoes should provide ample cushioning through the heel and the ball of the foot, while also supporting the arch. Wearing an orthotic shoe insert is one of the best ways to stretch the plantar fascia and prevent conditions such as heel spurs. Stretching the foot and calf is also helpful in preventing damage. Athletes in particular should make sure to stretch prior to any physical activity. Stretching helps prevent heel spurs by making tissue stronger as well as more flexible. In addition, easing into a new or increasingly difficult routine should be done to help avoid strain on the heel and surrounding tissue.
The Best Ways To Protect Against Calcaneal Spur
Overview
If you're feeling pain on the bottom of your foot near your heel, pain after exercise or activity, or pain first thing in the morning or after a long period of sitting, then you may have a heel spur. Heel spurs don't have a magic cure, but you can take steps to ease the pain and to eventually get rid of them.
Causes
The cause of heel spurs is excessive strain placed on the plantar fascia over a long period of time, as a result of different factors. These factors include incorrect gait, being overweight, ageing or being in a job that requires a lot of standing on hard floors. It is usually a combination of any of these factors that will bring on the development of heel spurs.
Symptoms
Heel spurs may or may not cause symptoms. Symptoms are usually related to the plantar fasciitis. You may experience significant pain. Your heel pain may be worse in the morning when you first wake up or during certain activities.
Diagnosis
Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.
Non Surgical Treatment
In some cases, heel spur pain may not be resolved through conservative treatment options. In those cases, cortisone injections may be used to reduce inflammation associated with the condition, helping to reduce discomfort. However, treatment options such as these must be discussed in detail with your physician, since more serious forms of treatment could yield negative side effects, such as atrophy of the heel's fat pad, or the rupture of the plantar fascia ligament. Although such side effects are rare, they are potential problems that could deliver added heel pain.
Surgical Treatment
Usually, heel spurs are curable with conservative treatment. If not, heel spurs are curable with surgery, although there is the possibility of them growing back. About 10% of those who continue to see a physician for plantar fascitis have it for more than a year. If there is limited success after approximately one year of conservative treatment, patients are often advised to have surgery.
Physiotherapy For Bursitis Of The Foot
Overview
Bursitis accounts for 0.4% of all visits to primary care clinics. The most common locations of bursitis are the subdeltoid, olecranon, ischial, trochanteric, and prepatellar bursae. The incidence of bursitis is higher in athletes, reaching levels as high as 10% in runners. Approximately 85% of cases of septic superficial bursitis occur in men. A French study aimed at assessing the prevalence of knee bursitis in the working population found that most cases occurred in male workers whose occupations involved heavy workloads and frequent kneeling. Mortality in patients with bursitis is very low. The prognosis is good, with the vast majority of patients receiving outpatient follow-up and treatment.
Causes
High impact activity, such as running. Trauma to the heel such as jumping from a height. Increase in training levels. Lack of shock absorbency in the trainers worn. Worn running shoes. Poor biomechanics. Loss of the fat pad under the heel. Increase in weight.
Symptoms
Pain or tenderness at the back of the heel around the Achilles region. Increased pain during activities with strong, repetitive calf contractions, walking (uphill), stair climbing, running, jumping. Pain may be worse with rest after activity (that night or the next morning) or at the beginning of the excercise. Pain when wearing shoes and the heel is getting rubbed. Bump forming on the back of the heel. Limping. Stiffness. Decreased range of motion. Redness and warmth (if the bursa gets infected).
Diagnosis
Your doctor will check for bursitis by asking questions about your past health and recent activities and by examining the area. If your symptoms are severe or get worse even after treatment, you may need other tests. Your doctor may drain fluid from the bursa through a needle (aspiration) and test it for infection. Or you may need X-rays, an MRI, or an ultrasound.
Non Surgical Treatment
Gradual and progressive stretching of the Achilles tendon. Exercises to strengthen and support the ankle. Rest or reduced weight bearing activities. Immobilisation in a cast for 4-6 weeks for severe cases. Ice. Proper fitting and supportive footwear. Massage. Joint mobilisation. Anti-inflammatory medications: only if this does not have adverse results with the patient's current medication. Heel pads and heel lifts. Footwear Advice. Strapping and padding Orthoses/innersoles. The orthotics prescribed and designed by the podiatrists at the Heel and Arch Pain Clinic (affiliated with Beyond Podiatry) are made to align the foot in the correct posture. Surgery is indicated in severe cases when conservative treatment has not resolved the problem.
Surgical Treatment
Surgery. Though rare, particularly challenging cases of retrocalcaneal bursitis might warrant a bursectomy, in which the troublesome bursa is removed from the back of the ankle. Surgery can be effective, but operating on this boney area can cause complications, such as trouble with skin healing at the incision site. In addition to removing the bursa, a doctor may use the surgery to treat another condition associated with the retrocalcaneal bursitis. For example, a surgeon may remove a sliver of bone from the back of the heel to alter foot mechanics and reduce future friction. Any bone spurs located where the Achilles attaches to the heel may also be removed. Regardless of the conservative treatment that is provided, it is important to wait until all pain and swelling around the back of the heel is gone before resuming activities. This may take several weeks. Once symptoms are gone, a patient may make a gradual return to his or her activity level before their bursitis symptoms began. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause bursitis symptoms to flare up again.
Bursitis accounts for 0.4% of all visits to primary care clinics. The most common locations of bursitis are the subdeltoid, olecranon, ischial, trochanteric, and prepatellar bursae. The incidence of bursitis is higher in athletes, reaching levels as high as 10% in runners. Approximately 85% of cases of septic superficial bursitis occur in men. A French study aimed at assessing the prevalence of knee bursitis in the working population found that most cases occurred in male workers whose occupations involved heavy workloads and frequent kneeling. Mortality in patients with bursitis is very low. The prognosis is good, with the vast majority of patients receiving outpatient follow-up and treatment.
Causes
High impact activity, such as running. Trauma to the heel such as jumping from a height. Increase in training levels. Lack of shock absorbency in the trainers worn. Worn running shoes. Poor biomechanics. Loss of the fat pad under the heel. Increase in weight.
Symptoms
Pain or tenderness at the back of the heel around the Achilles region. Increased pain during activities with strong, repetitive calf contractions, walking (uphill), stair climbing, running, jumping. Pain may be worse with rest after activity (that night or the next morning) or at the beginning of the excercise. Pain when wearing shoes and the heel is getting rubbed. Bump forming on the back of the heel. Limping. Stiffness. Decreased range of motion. Redness and warmth (if the bursa gets infected).
Diagnosis
Your doctor will check for bursitis by asking questions about your past health and recent activities and by examining the area. If your symptoms are severe or get worse even after treatment, you may need other tests. Your doctor may drain fluid from the bursa through a needle (aspiration) and test it for infection. Or you may need X-rays, an MRI, or an ultrasound.
Non Surgical Treatment
Gradual and progressive stretching of the Achilles tendon. Exercises to strengthen and support the ankle. Rest or reduced weight bearing activities. Immobilisation in a cast for 4-6 weeks for severe cases. Ice. Proper fitting and supportive footwear. Massage. Joint mobilisation. Anti-inflammatory medications: only if this does not have adverse results with the patient's current medication. Heel pads and heel lifts. Footwear Advice. Strapping and padding Orthoses/innersoles. The orthotics prescribed and designed by the podiatrists at the Heel and Arch Pain Clinic (affiliated with Beyond Podiatry) are made to align the foot in the correct posture. Surgery is indicated in severe cases when conservative treatment has not resolved the problem.
Surgical Treatment
Surgery. Though rare, particularly challenging cases of retrocalcaneal bursitis might warrant a bursectomy, in which the troublesome bursa is removed from the back of the ankle. Surgery can be effective, but operating on this boney area can cause complications, such as trouble with skin healing at the incision site. In addition to removing the bursa, a doctor may use the surgery to treat another condition associated with the retrocalcaneal bursitis. For example, a surgeon may remove a sliver of bone from the back of the heel to alter foot mechanics and reduce future friction. Any bone spurs located where the Achilles attaches to the heel may also be removed. Regardless of the conservative treatment that is provided, it is important to wait until all pain and swelling around the back of the heel is gone before resuming activities. This may take several weeks. Once symptoms are gone, a patient may make a gradual return to his or her activity level before their bursitis symptoms began. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause bursitis symptoms to flare up again.
Hammertoe Pain Remedies
Overview
Hammertoe is a condition in which the toes of your feet become contracted into an upside-down "V" shape, causing pain, pressure and, often, corns and calluses. hammertoe can develop on any of the toes, but generally affects the middle three toes, most often the second toe. The bones, muscles, ligaments and tendons of your feet normally are well-balanced to distribute your body's weight while standing, walking and running. When the first and second joints of your toes experience the prolonged stress that develops when the muscles that control them fail to work together properly, the pressure on the tendons that support them can lead to the curling or contraction known as hammertoe.
Causes
Hammer toe results from shoes that don?t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in one position long enough, the muscles tighten and cannot stretch out. Some other causes are diabetes, arthritis, neuromuscular disease, polio or trauma.
Symptoms
Well-developed hammertoes are distinctive due to the abnormal bent shape of the toe. However, there are many other common symptoms. Some symptoms may be present before the toe becomes overly bent or fixed in the contracted position. Often, before the toe becomes permanently contracted, there will be pain or irritation over the top of the toe, particularly over the joint. The symptoms are pronounced while wearing shoes due to the top of the toe rubbing against the upper portion of the shoe. Often, there is a significant amount of friction between the toe and the shoe or between the toe and the toes on either side of it. The corns may be soft or hard, depending on their location and age. The affected toe may also appear red with irritated skin. In more severe cases, blisters or open sores may form. Those with diabetes should Hammer toe take extra care if they develop any of these symptoms, as they could lead to further complications.
Diagnosis
The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.
Non Surgical Treatment
For hammertoes that are still flexible, a podiatrist might recommend padding or taping the toes to relieve pain and orthotic inserts for shoes to minimize pressure and keep the toe properly aligned. Anti-inflammatory drugs or corticosteroid injections can relieve pain and inflammation. For more advanced cases of hammertoe, a podiatrist might recommend a surgical procedure to cut the tendon, allowing the toe to straighten. For hammertoes that have become rigid, a more complicated surgery might be needed, during which the podiatrist removes part of the bone at the deformed joint to allow it to straighten.
Surgical Treatment
In more advanced cases of hammer toe, or when the accompanying pain cannot be relieved by conservative treatment, surgery may be required. Different types of surgical procedures are performed to correct hammer toe, depending on the location and extent of the problem. Surgical treatment is generally effective for both flexible and fixed (rigid) forms of hammer toe. Recurrence following surgery may develop in persons with flexible hammer toe, particularly if they resume wearing poorly-fitted shoes after the deformity is corrected.
Prevention
Skin creams can help maintain skin softness and pliability. A pumice stone or loofah sponge can help get rid of dead skin. Taking a warm footbath for 10 minutes two or three times a week will keep the feet relaxed and help prevent mild foot pain caused by fatigue. Adding 1/2 cup of Epsom salts increases circulation and adds other benefits. Taking footbaths only when the feet are painful is not as helpful.
Hammer Toes Definition
Overview
Hammer toes are classified based on the mobility of the toe joints. There are two types. Flexible and rigid. In a flexible hammertoe, the joint has the Hammer toes ability to move. This type of hammer toe can be straightened manually. A rigid hammer toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses.
Causes
Hammertoe is caused when muscles fail to work in a balanced manner and the toe joints bend to form the hammertoe shape. If they remain in this position, the muscles and tendons supporting them tighten and stay that way. Causes of hammertoe can include squeezing into a too-small or ill-fitting shoe or wearing high heels that jam your toes into a tight toe box. An injury such as badly stubbing your toe. Arthritis. Nerve and muscle damage from diseases such as diabetes,
Symptoms
At first, a hammertoe or mallet toe may maintain its flexibility and lie flat when you're not wearing crowded footwear. But eventually, the tendons of the toe may contract and tighten, causing your toe to become permanently stiff. Your shoes can rub against the raised portion of the toe or toes, causing painful corns or calluses.
Diagnosis
A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.
Non Surgical Treatment
What will a doctor do? Treat any foot complaints such as corns, calluses by periodically reducing the lesion and applying appropriate pads and dressings. Recommend the silicone toe prop. If an infection is present, then anti-septic dressings, antibiotics and pads to redistribute pressure away from the lesion may be necessary. In the case of a mallet toe, trigger toe or claw toe. If a corn occurs at the end of the toe, a silicone or leather prop may be used to straighten the toe. In a hammertoe deformity, a silicone prop to redistribute pressure away from a corn may be necessary. The doctor may give footwear advice. In severe cases, corrective surgery may be necessary. The doctor may recommend orthosis to correct a mechanical complaint of the foot, such as 3/4 length silicone insoles.
Surgical Treatment
Surgery to correct for a hammertoe may be performed as a day procedure. There are several different types of procedures that can be used depending on the foot structure and if the deformity is flexible or rigid.
Prevention
The best treatment is good prevention! Hammertoe can be prevented by wearing shoes with ample toe room, avoiding high heels, and wearing adjustable shoes to assure a looser fit. When buying shoes, shop at the end of the day when your feet are swollen from daily activity, try both shoes on to confirm they fit properly, and if necessary, visit a shoe repair store to see if they can stretch your shoes for a better fit.
Discover More About Overpronation Of The Feet
Overview
Overpronation is a term which is used more and more frequently by runners and exercisers these days, but what is overpronation and is it bad? Overpronation is excessive pronation of the feet when walking and running, and it can place people at risk of developing foot problems. Knowing the degree to which you pronate is important in order to select the correct footwear and exercise shoes. If you pronate excessively you could be placing an excessive strain on your feet, however overpronators can also place an excessive strain on the ankles, legs, knees, hips and lower back. Runners often claim to be an overpronator or even an underpronator or supinator. These terms may very well be viewed in a negative light when they really are not a problem at all. On the other hand people may be overpronators and not even know about it and could be at a high risk of developing a musculoskeletal problem.
Causes
Over-pronation may happen because the tissue that attaches to your foot bones is loose. You may be born with this problem or it may result from injuries or overuse, like from too much running.
Symptoms
People with overpronation may suffer from pain in the knees, hips, and low back. Overpronation itself does not necessarily cause any other symptoms but is a contributing factor of many foot conditions such as Plantar Facsiitis, Heel Spur Syndrome, Posterior Tibialis Tendon Rupture or Tendonitis, Hallux Valgus, Bunion Deformities, Metatarsalgia, Hallux Limitus or Hallux Rigidus, Hammer Toes, and Morton?s Neuroma.
Diagnosis
Your healthcare provider will ask about your symptoms, medical history, and activities and examine your feet. Your provider may watch you walk or run. Check the motion of your feet when they strike the ground. Look at your athletic shoes to see if they show an abnormal pattern of wear.
Non Surgical Treatment
Overpronation is a term used to describe excessive flattening of the plantar arch. Pronation is a normal part of our gait (the way we walk), and it comprises three movements: dorsiflexion, eversion, and abduction. Dorsiflexion is the upward movement of the foot, eversion describes the foot rolling in, and abduction is ?out toeing,? meaning your toes are moving away from the midline of your body. When these three motions are extreme or excessive, overpronation results. Overpronation is very common in people who have flexible flat feet. Flatfoot, or pes planus, is a condition that causes collapse of the arch during weight bearing. This flattening puts stress on the plantar fascia and the bones of the foot, resulting in pain and further breakdown.
Surgical Treatment
Subtalar Arthroereisis. The ankle and hindfoot bones/midfoot bones around the joint are fused, locking the bones in place and preventing all joint motion. This may also be done in combination with fusion at other joints. This is a very aggressive option usually reserved for extreme cases where no joint flexibility is present and/or the patient has severe arthritic changes in the joint.
Overpronation is a term which is used more and more frequently by runners and exercisers these days, but what is overpronation and is it bad? Overpronation is excessive pronation of the feet when walking and running, and it can place people at risk of developing foot problems. Knowing the degree to which you pronate is important in order to select the correct footwear and exercise shoes. If you pronate excessively you could be placing an excessive strain on your feet, however overpronators can also place an excessive strain on the ankles, legs, knees, hips and lower back. Runners often claim to be an overpronator or even an underpronator or supinator. These terms may very well be viewed in a negative light when they really are not a problem at all. On the other hand people may be overpronators and not even know about it and could be at a high risk of developing a musculoskeletal problem.
Causes
Over-pronation may happen because the tissue that attaches to your foot bones is loose. You may be born with this problem or it may result from injuries or overuse, like from too much running.
Symptoms
People with overpronation may suffer from pain in the knees, hips, and low back. Overpronation itself does not necessarily cause any other symptoms but is a contributing factor of many foot conditions such as Plantar Facsiitis, Heel Spur Syndrome, Posterior Tibialis Tendon Rupture or Tendonitis, Hallux Valgus, Bunion Deformities, Metatarsalgia, Hallux Limitus or Hallux Rigidus, Hammer Toes, and Morton?s Neuroma.
Diagnosis
Your healthcare provider will ask about your symptoms, medical history, and activities and examine your feet. Your provider may watch you walk or run. Check the motion of your feet when they strike the ground. Look at your athletic shoes to see if they show an abnormal pattern of wear.
Non Surgical Treatment
Overpronation is a term used to describe excessive flattening of the plantar arch. Pronation is a normal part of our gait (the way we walk), and it comprises three movements: dorsiflexion, eversion, and abduction. Dorsiflexion is the upward movement of the foot, eversion describes the foot rolling in, and abduction is ?out toeing,? meaning your toes are moving away from the midline of your body. When these three motions are extreme or excessive, overpronation results. Overpronation is very common in people who have flexible flat feet. Flatfoot, or pes planus, is a condition that causes collapse of the arch during weight bearing. This flattening puts stress on the plantar fascia and the bones of the foot, resulting in pain and further breakdown.
Surgical Treatment
Subtalar Arthroereisis. The ankle and hindfoot bones/midfoot bones around the joint are fused, locking the bones in place and preventing all joint motion. This may also be done in combination with fusion at other joints. This is a very aggressive option usually reserved for extreme cases where no joint flexibility is present and/or the patient has severe arthritic changes in the joint.
Rehab For Severs Disease
Overview
Sever's disease, also called calcaneal apophysitis, is a painful bone disorder that results from inflammation (swelling) of the growth plate in the heel. A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite, which is how bones grow. Sever's disease is a common cause of heel pain in growing kids, especially those who are physically active. It usually occurs during the growth spurt of adolescence, the approximately 2-year period in early puberty when kids grow most rapidly. This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys. Sever's disease rarely occurs in older teens because the back of the heel usually finishes growing by the age of 15, when the growth plate hardens and the growing bones fuse together into mature bone. Sever's disease is similar to Osgood-Schlatter disease, a condition that affects the bones in the knees.
Causes
Sever's disease is caused by repetitive tension and/or pressure on the growth center of the heel. Running and jumping place a large amount of pressure on the heels and can cause pain. Children with Sever's may limp or have an altered gait due to the pain. Risk factors for Sever's include tight calf muscles, weak ankle muscles, and alignment abnormalities at the foot and ankle. Sever's can also result from wearing shoes without sufficient heel padding or arch support.
Symptoms
Adolescents suffering from Sever?s disease usually complain of pain at the back of their heel which is often worse after exercising. It is most common between the ages of 10-12 in boys and 8-10 in girls due to the rapid growth spurts that occur during this time. It can however happen anytime up until the age of 15. Whilst most people present with pain worse in one foot, it is very common to have symptoms in both feet.
Diagnosis
In Sever's disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or she runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that your child's heel tendons have become tight.
Non Surgical Treatment
If your child lets you know that his heels are hurting, schedule a doctor's appointment. Your family doctor may or may not refer you to a podiatrist. Treatment for Sever's Disease typically consists of one or more of the following steps. Reducing physical activity. Because Sever's Disease appears to be most common in athletic children, reducing exercise periods will relieve pressure on the heel bones, thereby reducing pain. Your doctor may recommend that your child take a complete break from athletic activity for a set amount of time. Icing the heel bones can help to lower both inflammation and pain levels. Use a cold pack or wrap ice in a towel and apply it to the heels. A new exercise regimen that involves simple stretches designed to lengthen the calf muscles and tendons. Your doctor may prescribe the use of orthotic shoe inserts that will assist your child in maintaining a good level of physical activity. HTP Heel Seats may be an excellent option and have been purchased by many parents as an effective aide for children suffering from Sever's Disease. Read about HTP Heel Seats here and ask your doctor if they are right for your child's unique case. In extreme cases, a doctor may recommend a plaster cast or boot, but typically only if other less cumbersome solutions fail to reduce pain. Some doctors may prescribe anti-inflammatory medications. Never give these to a child yourself, without first seeking a doctor's advice. Some medications carry the risk of serious side effects for children. Only give medications if specifically prescribed your child's physician.
Surgical Treatment
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.
Sever's disease, also called calcaneal apophysitis, is a painful bone disorder that results from inflammation (swelling) of the growth plate in the heel. A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite, which is how bones grow. Sever's disease is a common cause of heel pain in growing kids, especially those who are physically active. It usually occurs during the growth spurt of adolescence, the approximately 2-year period in early puberty when kids grow most rapidly. This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys. Sever's disease rarely occurs in older teens because the back of the heel usually finishes growing by the age of 15, when the growth plate hardens and the growing bones fuse together into mature bone. Sever's disease is similar to Osgood-Schlatter disease, a condition that affects the bones in the knees.
Causes
Sever's disease is caused by repetitive tension and/or pressure on the growth center of the heel. Running and jumping place a large amount of pressure on the heels and can cause pain. Children with Sever's may limp or have an altered gait due to the pain. Risk factors for Sever's include tight calf muscles, weak ankle muscles, and alignment abnormalities at the foot and ankle. Sever's can also result from wearing shoes without sufficient heel padding or arch support.
Symptoms
Adolescents suffering from Sever?s disease usually complain of pain at the back of their heel which is often worse after exercising. It is most common between the ages of 10-12 in boys and 8-10 in girls due to the rapid growth spurts that occur during this time. It can however happen anytime up until the age of 15. Whilst most people present with pain worse in one foot, it is very common to have symptoms in both feet.
Diagnosis
In Sever's disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or she runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that your child's heel tendons have become tight.
Non Surgical Treatment
If your child lets you know that his heels are hurting, schedule a doctor's appointment. Your family doctor may or may not refer you to a podiatrist. Treatment for Sever's Disease typically consists of one or more of the following steps. Reducing physical activity. Because Sever's Disease appears to be most common in athletic children, reducing exercise periods will relieve pressure on the heel bones, thereby reducing pain. Your doctor may recommend that your child take a complete break from athletic activity for a set amount of time. Icing the heel bones can help to lower both inflammation and pain levels. Use a cold pack or wrap ice in a towel and apply it to the heels. A new exercise regimen that involves simple stretches designed to lengthen the calf muscles and tendons. Your doctor may prescribe the use of orthotic shoe inserts that will assist your child in maintaining a good level of physical activity. HTP Heel Seats may be an excellent option and have been purchased by many parents as an effective aide for children suffering from Sever's Disease. Read about HTP Heel Seats here and ask your doctor if they are right for your child's unique case. In extreme cases, a doctor may recommend a plaster cast or boot, but typically only if other less cumbersome solutions fail to reduce pain. Some doctors may prescribe anti-inflammatory medications. Never give these to a child yourself, without first seeking a doctor's advice. Some medications carry the risk of serious side effects for children. Only give medications if specifically prescribed your child's physician.
Surgical Treatment
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.
