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