Sever's injury; treat it with a heel cup: a randomized, crossover study with two insole alternatives

Perhamre, Stefan; Lundin, Fredrik; Norlin, Rolf; Klässbo, Maria

doi:10.1111/j.1600-0838.2010.01140.x

Cited by 38 publications

(69 citation statements)

References 9 publications

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“…The fissure was located on the margin of the Achilles tendon insertion, which is the center for traction in opposite directions between the Achilles tendon and the plantar structures. 15,16 The distal fragment in the present patients was approximately 10 mm long and was never dislocated or different in any other aspect. 1,13,19 The distal fragment is located in the area of the heel strike, and two of three tests in this study focused on that area.…”

Section: Discussionmentioning

confidence: 56%

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Sever’s Injury

Perhamre

Lazowska²,

Papageorgiou³

et al. 2013

J Am Podiatr Med Assoc

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Section: Discussionmentioning

confidence: 56%

“…15,16 Therefore, it is important to be able to clinically identify these children to provide them with the correct treatment. 15,16 Therefore, it is important to be able to clinically identify these children to provide them with the correct treatment.…”

Section: Methodsmentioning

confidence: 99%

Sever’s Injury

Perhamre

Lazowska²,

Papageorgiou³

et al. 2013

J Am Podiatr Med Assoc

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“…These included the use of heel raises [17,38,39,41,44], taping/padding [42,45], orthoses [17,38-41], and stretching of the gastrocnemius / soleus / achilles tendon complex [17,41,43,44]. …”

Section: Resultsmentioning

confidence: 99%

Effectiveness of interventions in reducing pain and maintaining physical activity in children and adolescents with calcaneal apophysitis (Sever's disease): a systematic review

James

Williams

Haines

2013

Journal of Foot and Ankle Research

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BackgroundCalcaneal apophysitis, also commonly known as sever’s disease, is a condition seen in children usually aged between 8–15 years. Conservative therapies, such as taping, heel lifts and orthotic intervention are accepted management practices for calcaneal apophysitis, though there is very little high quality research examining the efficacy of such treatment modalities. Previous narrative literature reviews and opinion pieces provide some evidence for the use of heel raises or orthoses. The aim of this manuscript was to complete a systemic review on the treatment options for calcaneal apophysitis as measured by pain reduction and maintenance of physical activity.MethodsA search strategy completed by two reviewers examined nine databases from inception to May 2012. Search terms included heel pain, children, adolescent, calcaneal apophysitis, sever’s disease, treatment, and management (full text publications, human studies). Systematic reviews, randomised control trials, case series, and case studies were included. The reference lists of the selected articles were also examined. The methodology, quality and risk of bias was examined and assessed using the PEDro scale.ResultsNine articles were retrieved including three clinical trials involving randomisation, two case series, two retrospective case reviews, and two case reports. Effect size calculations and a meta analysis were unable to be completed due to the limited data reported within the literature. Numerous treatment options were reported throughout the literature, though few were examined against a control or alternate treatment option in well-designed trials. The limited evidence indicated that orthoses provided greater short-term pain relief than heel raises. Health practitioners should view these results with caution, as there were apparent methodological problems with the employed study design and limited follow-up of participants.ConclusionThere is limited evidence to support the use of heel raises and orthoses for children who have heel pain related to calcaneal apophysitis. Further research is needed to generate higher quality evidence with larger sample sizes, and validated measures of pain and function to establish effective treatment approaches for children with calcaneal apophysitis.

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“…The orthoses used in the various studies included a rigid heel cup (molded plastazote orthosis) and a 5mm heel wedge. [1][2][3] Lastly, heel lifts were also found to be effective in reducing pain; however, many of the studies examined used heel lifts in combination with stretching and ice, limiting the ability to isolate heel lifts independently.…”

Section: Data Synthesismentioning

confidence: 95%

“…Level of evidence was assigned for each of the articles according to the Oxford Centre for Evidence-based Medicine criteria (levels [1][2][3][4][5]. In addition, the PEDro scale was used to assess the methodology, quality, and bias.…”

Section: Data Extractionmentioning

confidence: 99%

Heel Pain in Youth: A Guide to Potential Management Strategies

Weber¹,

Picha²,

McLeod³

2014

International Journal of Athletic Therapy and Training

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Calcaneal apophysitis, or Sever's disease, is common among physically active youth between the ages of 8-15. This condition is related to skeletal growth during maturation and relief often comes once growth is complete. However, it is not feasible to limit participation in physical activity until growth ceases; therefore, it is important to determine effective interventions to regulate pain while continuing participation. A search of the literature yielded nine studies that met the inclusion criteria and were included for data analysis. Within these publications, many treatment methods were suggested, including nonsteroidal anti-inflammatory drugs (NSAIDs), taping, orthoses, heel lifts, stretching, activity modification, and ice. However, few of the treatment options were compared with a control group. Analysis revealed that clinicians should provide treatments with caution when treating patients suffering from Sever's disease, understanding that strong evidence is not supportive of one treatment option alone. Data are limited for individual treatments related to calcaneal apophysitis and more research in this area is warranted. Clinicians should work with patients on an individual basis to determine if one form of treatment provides a reduction of pain and allows that patient to continue with activity. ReferenceJames A, Williams C, Haines T. Effectiveness of interventions in reducing pain and maintaining physical activity in children and adolescents with calcaneal apophysitis (Sever's disease): a systematic review.

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Sever's injury; treat it with a heel cup: a randomized, crossover study with two insole alternatives

Cited by 38 publications

References 9 publications

Sever’s Injury

Sever’s Injury

Effectiveness of interventions in reducing pain and maintaining physical activity in children and adolescents with calcaneal apophysitis (Sever's disease): a systematic review

Heel Pain in Youth: A Guide to Potential Management Strategies

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