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please help me with calcaneal apophysitis or severs disease

Posted by matt on 6/24/04 at 20:10 (153867)

My name is Matt. I just turned 13, and I am in tons of pain when I walk. I havent been able to run, jump, or jog for a year now. I love to be active and play sports before the worst thing that ever has happened to me came last summer of 2003. It all started when i was jogging last summer every day. I started getting pain in my heel area. I was still able to run then, but one day I hit a jump on my bike and when I landed, I guess I came down on my heel really hard. As soon as I landed I felt the worst pain iv ever had in my life in my heel. I couldnt walk at all. I went to the foot doctor and he diagnosed me with calcaneal apophysitis or sever's disease. Well football season was two weeks from the time I saw the doctor. The doctor told me not to play football right away, but I did anyway because I wanted to make a good impression with my coaches. Well I was sprinting on it all season and it got really bad. To the point were I could barely walk. I went to the same foot doctor and he told me to keep icing it, stretching it, and then he assigned me to physical therapy. Physical therapy did nothing for it. Between doing football and being in gym class my heel got really bad. I then was made orthotics but they didnt help. My foot doctor made me get MRI, Bone Scan, and X rays and everything came back normal but it showed my heel being inflammed a little but he said it was normal. Then the physical therapists made me wear a walking boot for about a month or two. The boot did nothing. So then the foot doctor decided to put me in a cast and have crutches. I was in a cast for 3 weeks and when I got out of that my foot was so much worse! I could barely put any pressure on it then. So after the cast i was forced to stay on crutches for about 9 more weeks. In those 9 weeks i recieved a Cortozone shot in my heel and that did nothing. I also was on ibuprophen for the pain. I then managed to get off the crutches after about 9 weeks and went back to the walking boot. About a month ago I went for a second opinion from another doctor. He agreed that it was calcaneal apophysitis or severs disease and just told me to rest. I wrote you this e mail because my dad was trying to get you to look at me because my physical therapist said you were the best. Well if you could PLEASE tell me any sugestions or what to do about this i would REALLY appreciate it. Football season is comming up soon and its so frustrating when i can barely walk and i cant run. I really like to play football this year but I dont think its going to happen. Everyone jus tells me to be patient but its been over a year and i cant take it anymore! Well thanks for reading this and if you could write me back tell me any suggestions you have or if you really think i have calcaneal apophysitis.
Thank you,

Re: please help me with calcaneal apophysitis or severs disease

Ed Davis, DPM on 6/24/04 at 20:45 (153869)

Sorry to see that you had to be put through so much. I am a foot doctor who practices in a community with a lot of young families so I see lots of patients with Sever's disease. It is EASILY cured by making an appropriate orthotic (shoe insert). See http://www.acfas.org to find a practitioner near you.

Re: please help me with calcaneal apophysitis or severs disease

Dorothy on 6/24/04 at 21:18 (153872)

Dr. Davis -

Matt's post kind of got to me. Since his post said that he had had an orthotic made and it didn't help his problem, maybe you could tell him some fundamentals about what an 'appropriate orthotic' for Sever's disease might be...or some similar advice. It sounds as if he has been to several practitioners in his area so finding practitioners seems not to be a problem for him.

Maybe other people here - parents, for example - can also offer some advice to him. It must be encouraging to Matt to read your words 'It is EASILY cured by making an approprite orthotic...' so that he knows there is hope for him, but perhaps frustrating,not knowing how to go about getting that curative orthotic and how is it different from the orthotic he already has... I don't know. He's 13 and sounds worried and frustrated and sad, ya know??

Re: please help me with calcaneal apophysitis or severs disease

Ed Davis, DPM on 6/24/04 at 21:56 (153873)


Sorry -- I missed the sentence in which he mentioned he had obtained orthotics.

It is a bit difficult to describe what makes an orthotic presecription 'right' -- almost like asking an optometrist what make an eyeglass prescription right. So I have to make some assumptions, that is, the orthotics were made from a cast of his foot with the foot held in the proper position. Beyond that, features that are very important include a deep heel cup, that is, the part of the orthotic that the heel bone sits in should be at least 18 to 22mm from the lowest to the highest part. Also, that deep heel cup should be posted (wedged) in a fashion to minimize side to side roll which is the prime irritant. The growth plate get irritated when there is too much motion between it and the main part of the heel bone.

It is also important to make sure that there is adequate dorsiflexion, that is, backward motion of the foot on the leg. Think of the foot being at a right angle (90 degrees) to the leg; now it should go back another 15 degrees with the knee straight.

I have never encountered a patient with calcaneal apophysitis that has not been cured by the above so my suspicion is that the orthotic need be looked at carefully.

I realize that Matt has been to a lot of practitioners but would rather have him just see one person -- the right person who knows how to handle this properly. Matt -- where do you live? Perhaps I know someone in your area.

Re: please help me with calcaneal apophysitis or severs disease

cindym on 2/09/06 at 19:28 (193175)

What ever happened to Matt? My son has had sever disease for years. We have been to all the doctors, had orthotics, heel cushions, etc and nothing works. My son just suffer through. I just wonder if Matt still has problems or not 2 years later.

Re: please help me with calcaneal apophysitis or severs disease

jon s on 3/30/06 at 10:19 (196526)

hi, mi name is jon. Im an active skateboarder that has been doing it all day long since i was nine. When i was a couple months into my 14th year, i got severd disease. It was also like matt the worst thing that has happened to me. Just because it is so frustrating. I have to think about my heels all the time and worry about it. I stretch like a maniac and that helps i guess. Im almost 16 so im hoping that i will grow out of it soon. I also had orthotics made when i first got this disease and they did not seem to do much. Upon going to a diff. physical therapist he told me that they were not addequite at all in supporting my flat feet at all so im in the process of getting some new ones made. Im just trying to be patient. Im forced into tears most of the nights that i hurt myself because it is so depressing. Does anyone have some encouraging words about when it should go away or first hand experiences it would be appreciated, thanks.