How Do I Treat Severs Disease From Home?

Overview


Sever condition is an inflammation of the growth plate of the bone at the back of the heel (apophysitis of the calcaneus). The inflammation of Sever condition is at the point where the Achilles tendon attaches to the back of the heel bone. What causes Sever condition? Sever condition is caused by sprain injury where the Achilles tendon attaches to the calcaneus bone at the back of the heel. Sever condition occurs in adolescent or older children, particularly active boys. It can be very painful. It is one of those conditions commonly referred to as "growing pains." Patients are evaluated for signs of conditions that can mimic Sever condition, such as ankylosing spondylitis and other forms of arthritis. Usually Sever condition is self-limited; that is, it disappears as the child ages.


Causes


The pain of Severs usually occurs because of inflammation and micro-trauma to the growth plate of the heel bone. This can be caused by a sudden increase in activity, running on very hard surfaces, a growth spurt, tight muscles or feet that roll in.


Symptoms


Adolescents suffering from Sever?s disease usually complain of pain at the back of their heel which is often worse after exercising. It is most common between the ages of 10-12 in boys and 8-10 in girls due to the rapid growth spurts that occur during this time. It can however happen anytime up until the age of 15. Whilst most people present with pain worse in one foot, it is very common to have symptoms in both feet.


Diagnosis


Sever?s disease can be diagnosed based on the symptoms your child has. Your child?s doctor will conduct a physical examination by squeezing different parts of your child?s foot to see if they cause any pain. An X-ray may be used to rule out other problems, such as a broken bone or fracture.


Non Surgical Treatment


Treatment may consist of one or more of the following, Elevating the heel, Stretching hamstring and calf muscles 2-3 times daily, Using R.I.C.E. (Rest, Ice, Compression, Elevation), Foot orthotics, Medication, Physical therapy, Icing daily (morning), Heating therapy, Open back shoe are best and avoid high heel shoe. The Strickland Protocol has shown a positive response in patients with a mean return to sport in less than 3 weeks.


Surgical Treatment


The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.

Tag : SeversDisease,CalcanealApophysitis

Acquired Flat Foot Tibialis Posterior Muscle


Overview
PTTD is a common condition treated by foot and ankle specialists. Although there is a role for surgical treatment of PTTD, conservative care often can prevent or delay surgical intervention. Decreasing inflammation and stabilizing the affected joints associated with the posterior tibial tendon can decrease pain and increase functional levels. With many different modalities available, aggressive nonoperative methods should be considered in the treatment of PTTD, including early immobilization, the use of long-term bracing, physical therapy, and anti-inflammatory medications. If these methods fail, proper evaluation and work-up for surgical intervention should be employed.
Acquired Flat Feet

Causes
Obesity - Overtime if your body is carrying those extra pounds, you can potentially injure your feet. The extra weight puts pressure on the ligaments that support your feet. Also being over weight can lead to type two diabetes which also can attribute to AAFD. Diabetes - Diabetes can also play a role in Adult Acquired Flatfoot Deformity. Diabetes can cause damage to ligaments, which support your feet and other bones in your body. In addition to damaged ligaments, uncontrolled diabetes can lead to ulcers on your feet. When the arches fall in the feet, the front of the foot is wider, and outer aspects of the foot can start to rub in your shoe wear. Patients with uncontrolled diabetes may not notice or have symptoms of pain due to nerve damage. Diabetic patient don?t see they have a problem, and other complications occur in the feet such as ulcers and wounds. Hypertension - High blood pressure cause arteries narrow overtime, which could decrease blood flow to ligaments. The blood flow to the ligaments is what keeps the foot arches healthy, and supportive. Arthritis - Arthritis can form in an old injury overtime this can lead to flatfeet as well. Arthritis is painful as well which contributes to the increased pain of AAFD. Injury - Injuries are a common reason as well for AAFD. Stress from impact sports. Ligament damage from injury can cause the bones of the foot to fallout of ailment. Overtime the ligaments will tear and result in complete flattening of feet.

Symptoms
Pain and swelling around the inside aspect of the ankle initially. Later, the arch of the foot may fall (foot becomes flat), this change leads to walking to become difficult and painful, as well as standing for long periods. As the flat foot becomes established, pain may progress to the outer part of the ankle. Eventually, arthritis may develop.

Diagnosis
Posterior Tibial Tendon Dysfunction is diagnosed with careful clinical observation of the patient?s gait (walking), range of motion testing for the foot and ankle joints, and diagnostic imaging. People with flatfoot deformity walk with the heel angled outward, also called over-pronation. Although it is normal for the arch to impact the ground for shock absorption, people with PTTD have an arch that fully collapses to the ground and does not reform an arch during the entire gait period. After evaluating the ambulation pattern, the foot and ankle range of motion should be tested. Usually the affected foot will have decreased motion to the ankle joint and the hindfoot. Muscle strength may also be weaker as well. An easy test to perform for PTTD is the single heel raise where the patient is asked to raise up on the ball of his or her effected foot. A normal foot type can lift up on the toes without pain and the heel will invert slightly once the person has fully raised the heel up during the test. In early phases of PTTD the patient may be able to lift up the heel but the heel will not invert. An elongated or torn posterior tibial tendon, which is a mid to late finding of PTTD, will prohibit the patient from fully rising up on the heel and will cause intense pain to the arch. Finally diagnostic imaging, although used alone cannot diagnose PTTD, can provide additional information for an accurate diagnosis of flatfoot deformity. Xrays of the foot can show the practitioner important angular relationships of the hindfoot and forefoot which help diagnose flatfoot deformity. Most of the time, an MRI is not needed to diagnose PTTD but is a tool that should be considered in advanced cases of flatfoot deformity. If a partial tear of the posterior tibial tendon is of concern, then an MRI can show the anatomic location of the tear and the extensiveness of the injury.

Non surgical Treatment
The following is a summary of conservative treatments for acquired flatfoot. Stage 1, NSAIDs and short-leg walking cast or walker boot for 6-8 weeks; full-length semirigid custom molded orthosis, physical therapy. Stage 2, UCBL orthosis or short articulated ankle orthosis. Stage 3, Molded AFO, double-upright brace, or patellar tendon-bearing brace. Stage 4, Molded AFO, double-upright brace, or patellar tendon-bearing brace.
Adult Acquired Flat Feet

Surgical Treatment
If initial conservative therapy of posterior tibial tendon insufficiency fails, surgical treatment is considered. Operative treatment of stage 1 disease involves release of the tendon sheath, tenosynovectomy, debridement of the tendon with excision of flap tears, and repair of longitudinal tears. A short-leg walking cast is worn for 3 weeks postoperatively. Teasdall and Johnson reported complete relief of pain in 74% of 14 patients undergoing this treatment regimen for stage 1 disease. Surgical debridement of tenosynovitis in early stages is believed to possibly prevent progression of disease to later stages of dysfunction.

Tag : AdultAquiredFlatFoot