Posterior calcaneus Osteochondrosis or Sever disease
What is Sever’s disease?
It is a growth disorder in the young adolescent (between 8 and 15 years) also called osteochondrosis or posterior apophyseal or apophysitis or calcaneus osteochondritis . During growth, changes in the dimensions of the muscles, tendons and bones do not always occur in a harmonious, regular, symmetrical and constant manner, but sometimes these elements are not synchronous. This disrupts the conjugation cartilage located behind and which is the active zone during growth.
It is a tatalgia that becomes incapacitating causing a lameness, a difficulty in the footing and a reduction of the sporting performance even, an impossibility to practice sport simply. It occurs as a result of weight gain or as a result of intensive and repeated efforts.
These disorders exist elsewhere in the young?
In the knee, especially in the insertion of the patellar tendon on the growth cartilage of the anterior tibial tuberosity, and is called Osgood-Schlatter disease, or other cartilage growth disease.
Should we plaster?
Some suggest it especially if there is an achillian tendinitis, but local care, rest and patience are most common.
Essentially radiological, a comparative X-ray shows an elaboration of the posterior process of calcaneus. It is the differential diagnosis that must be made with a fracture of the calcaneus or post-traumatic apophysial detachment or osteomyelitis.
Should we operate?
Practically never, one must know to wait because the evolution is sometimes very long and can be done over several months.
How to treat this disease?
Rest is the key word of treatment. Sporting rest of course but also discharges the foot if necessary, with canes crutches. Local treatments are efficient: cold water baths, Icing, local NSAIDs, analgesics, silicone heel, basketball with anti-shock sole (containing a layer of air in the sole under the heel). Ecxeptionally: Shock waves by a physiotherapist in severe forms.
- Growth Cartilage: it is a cartilage located in the zone of growth, there are in each bone.
- Talalgia: heel pain often associated with micro trauma, irradiated towards the insertion of BP.
- Achilles tendinitis: inflammation of the tendon often accompanying this disease whose treatment must take into account the tendon component.