What is the Syndrome of Sever?
The syndrome of Sever, also known as disease Sever or apofisitis calcánea, is a common condition that affects adolescents assets, in particular to those who participate in sports that involve jumping and racing. This lesion, which affects the heel in growth, can be painful and limit participation in physical activities. In this article, we explore in-depth the syndrome, Sever, from its definition to its treatment, rehabilitation, and safe return to sports action.
Definition
The syndrome Sever is a condition that occurs when the growth plate in the heel (the epiphysis calcánea) inflamed due to excessive stress and repetitive in the area. This epiphysis is a crucial part of the process of bone growth and is located in the back of the heel. When the calf muscles pull excessively on the Achilles tendon, this can cause pain and swelling in the area.
Causes
The syndrome Sever is more common in adolescents, especially in those that are experiencing a rapid growth. The main causes include:
- Bone growth: The growth plate of the heel is not yet completely fused with the bone, which makes them more susceptible to injury.
- High-impact activities: Participate in sports such as running, jumping and playing basketball or football, they exert a significant pressure on the heel, can increase the risk.
- Inappropriate footwear: Wear shoes that do not provide adequate support or have insufficient damping can aggravate the condition.
Other causes can be:
- Triceps surae shorter.
- Weak ability to flex the ankle upward (dorsiflexion).
- Perform training activities on hard surfaces.
- Position of the knees, arched or genu varus.
- Submit a walk with high bow or a flat foot.
- Difference in length between the lower extremities.
- Also, it is common to see symptoms of this condition in children with overweight due to excess weight also generates an overload on the heel bone.
Symptoms
To identify the disease Sever, it is important to pay attention to the following symptoms:
- Pain noticeable on the back or underside of the heel, which tends to intensify after the practice of physical activities or long walks.
- Possible swelling and redness in the heel area.
- Possible lameness in the affected child.
- Up with the tip of the foot, as a way to reduce the pain.
- Difficulties to run, jump, or engage in physical activities.
- Pain when you press the sides of the heel.
Diagnosis
The diagnosis of the syndrome Sever is usually done by using:
- Clinical history: The physical therapist will gather information about your symptoms and activities of the patient.
- Physical exam: You will perform a physical assessment to identify areas of pain and tenderness in the heel.
- Tests of image and sound: In some cases, you may perform ultrasound (ultrasound), x-rays or examination tomographic magnetic resonance imaging (MRI) to rule out other injuries and assess the state of the cartilage growth.
Treatment
The treatment of the syndrome of Sever is focused on relieving the pain and promote healing. Common strategies include:
- Rest and limitation of activities: to Reduce or avoid high-impact activities to allow the heel to recover.
- Physical therapy: exercises to stretch and strengthen the calf muscles and the Achilles tendon may help to relieve the tension on the heel.
- Ice: Apply ice to the affected area can reduce the inflammation and relieve the pain.
- Suitable footwear: Choose shoes with good support and cushioning can reduce the pressure on the heel.
Rehabilitation
Rehabilitation is essential to ensure a full recovery. This may include:
- Sporting break, accompanied by adjustments in the technical or sporting movement.
- Cold therapy (cryotherapy).
- Routine of exercises to stretch the muscle triceps sural.
- Exercises isometric strengthening of the muscles that flex the foot upward.
- Statement on the use of devices of dorsiflexion night.
- Techniques of stretching and relaxation of the plantar fascia.
- Mobilizations soft aimed at the joint, subtalar, and the posterior region of the foot.
- Application of electroanalgesia or use of electrical nerve stimulation transcutaneous (TENS).
- Ultrasound therapy for therapeutic purposes.
- Training for the rehabilitation of gait, in case of indicating the immobilization with casts (2-4 weeks) or the use of crutches (usually recommended in severe cases).
- Application of kinesiotaping or kinesio taping.
Prognosis
With the appropriate care, syndrome, or disease Sever present a positive predictive, and generally disappears in a period which varies between 2 weeks and 2 months, without causing future problems. The sooner you address this condition, the quicker the recovery. Most children can return to their physical activities without difficulty once they are gone the pain and other symptoms.
It is essential to note that, although this condition is usually resolved in an effective manner, there is the chance it will come back if you do not implement preventive long-term measures to protect the heel during the period of growth of the child. One of the preventive measures most essential is the use of appropriate footwear. High-quality running shoes, with a good support in the arch of the foot and padded soles help to reduce the pressure on the heel. Other preventive actions include conducting constant of stretching exercises and the application of ice packs in the heel after sports activities are intense. Once that concludes the process of bone growth, the disease rarely recurs.
Back to the action
The return to sports activities should be supervised by a physical therapist or doctor. It is important to ensure that the adolescent is fully recovered and has reached his previous level of strength and flexibility before resuming high-impact activities.
In summary, the syndrome Sever is a condition that is common in active adolescents which can cause pain in the heel. With the proper diagnosis and treatment, followed by proper rehabilitation, young athletes can make a full recovery and return safely to their physical activities favorite. It is always essential to seek the guidance of a health care professional to manage this condition effectively.
Note: this article is only intended to be informational use. In any case self-diagnose. If you suffer from any medical condition, we recommend that you go to your physical therapy clinic of confidence.
Cedric Arregui Guivarch
National Coach of Basketball (CES 2014)
Webgrafía and Bibliography
- DISEASE SEVER, WHAT IS IT AND WHY DOES IT OCCUR?, of fisioterapia-online.com
- Syndrome, Sever, of fisioterapia-online.com
- Pediatric Pain Syndromes and Noninflammatory Musculoskeletal Pain, of the National Library of Medicine
- Sever’s disease, from Wikipedia
