Severs Disease Traction apophysitis at the Achilles Tendon - PowerPoint PPT Presentation

Sever’s Disease Traction apophysitis at the Achilles Tendon Insertion

Presentation  12 year old male  Rugby player  Extremely hard playing surfaces due to drought  Pain - posterio-plantar aspect of calcaneus

Negative Lunge test • Low supination • resistance Trendelenberg with • single knee bend Thomas test negative • Tibial valgum

Anterior pelvic tilt • Core weakness • Tight hip flexors • Proximal weakness is driving functional pronation moments. Reduced calf/ Achilles length is ^ traction at calcaneal apophysis.

Assessment & Differential Diagnosis  Clinical symptoms & gait pattern  Xray films to rule out other conditions  Calcaneal apophysitis- ‘severs’

Orthotic Therapy Formthotics  Why were Formthotics used? – Increase shock absorption – Maintain fatty pad of heel under calcaneus – Increase weight bearing surface of foot – Control excessive pronation  What density was used and why? – DUAL – For above reasons and for increased cushioning  What postings were used? – Lateral forefoot post from styloid

Other treatment modalities  Ice  Tuli Heel Cups  Stretching & Strengthening Exercises- calf complex

Results  80% improved  Some soreness with rugby only, which settles quickly