Sever’s Disease Stretches

| August 19, 2013 | Reply

Sever’s disease (also known as calcaneal apophysitis) is a dysfunction that occurs when the growth plate – that is, the growing part of the heel – is affected by inflammation, ultimately resulting in pain and discomfort sensed in parts of the lower body. Due to its nature, this disorder most frequently affects children between the ages of 8 and 15 years (and especially those who wade in sports activities), but can be seldomly seen also in older individuals. Luckily, Sever’s disease can be treated to a significant or even to a full extent by performing a series of selected stretches.

Causes

severs diseaseThe main reason for a child to encounter Sever’s disease is the faster rate of growth that the heel bone has during early puberty in comparison with the rate in which the leg muscles and tendons are developed; as a result, the muscles and tendons in the area end up being tight, thusly bringing about reduced flexibility to the heels and ultimately putting pressure on the growth plate.

Other causes contributing to the appearance of Sever’s disease are:

  • Increased running or jumping activity
  • Tightened hamstrings
  • Stiff calf muscles
  • Prolonged standing, which keeps the heel under continuous pressure
  • A flat or high arch of the foot, that can later also result in achilles tendon pain
  • Excess body weight
  • Improper footwear

Symptoms

Generally, the main warning signs of Sever’s disease are:

  • Sore heels, with the pain becoming more intense after physical activity (walking, running, jumping etc.)
  • Discomfort or stiffness
  • Limping/tiptoeing
  • Swelling and redness in the heel, which however are rarely evident (typically, the external appearance of the heel seems normal)

A common way of identifying the occurrence of the problem in that spot and not in the achilles tendon or the plantar fascia is the “squeeze test” on several parts of the foot (to find out if pain is triggered), which is carried out during a physical examination by a doctor.

Sever’s Disease Stretching Exercises

Below are some of the most popular stretches for dealing with Sever’s disease; considering that these exercises are mostly carried out by children, it is vital that they are performed in a controlled manner and under supervision by an expert, at least during the first attempts.

  • Since tightened hamstring muscles are in many cases to blame for Sever’s diseases, the classic seated hamstring stretch, which is described here, can offer valuable help (you can also find a few other hamstring stretches right here).
  • Stiff calf muscles can be loosened by that stretch: sit on the edge of a chair and lift up your legs so that only their toes remain in contact with the floor; you can perform this stretch either in its active form or in a more dynamic one; if you choose to do the latter, 10-15 repetitions, in sets of 3, should be fine to start with.
  • Another passive calf stretch – presented here –, ideal for dealing Sever’s disease, is the one that involves standing in front of a wall, leaning towards it while pushing your hips forward (photo 2).
  • Passively stretching your gastrocnemius; stand on the edge of a step (with the front part of your feet on the step and the heels off) and gently push the heel of the left foot down, leaving the gravity to do the rest; hold that position for some seconds; then, repeat with the other leg! Another variation of this stretch is shown on photo 3. Another option for an efficient gastrocnemius stretch that is able to relieve Sever’s Disease is to lie supine with your knees straigthened and with the help of a partner or by means of  a belt to raise your left foot without bending your knees. Repeat with the right foot (Photo 4)
  • Arch stretching (photo 5) is also a great way for contending with Sever’s disease and the heel pain associated with it; so, here are three simple and effective stretches of this type; stand in front of a wall and put the big toe of your left foot onto it; now, slowly, begin sliding your foot to the floor, and at some point, you will feel a nice stretch. To perform the second stretch, leave a towel on the floor and try to grab it with your toes while slightly pulling it towards you. A third one (dynamic): put a tennis ball on the floor and roll the arch of your foot over it.

For the static/active/passive stretches, hold for 20-30 seconds, carrying out up to 10 repetitions for each static/active stretch. Most of the previously mentioned static stretches can be performed in a dynamic way and the opposite. For even better results you can apply Isometric, Active Isolated and PNF forms of the previously described stretces. Also, do not forget to stretch both legs, even if only one heel is harassed by the pain! Moreover, always consult a doctor before beginning an exercise program for Sever’s disease, either for your or your children.

Photos & Videos

In order to better understand the previously described stretches you should have a look at the multimedia below:

seated hamstrings stretch

Photo 1 – Seated hamstrings stretch

passive calf stretch

Photo 2- Passive calf stretch

Passive gastrocnemious stretch

Photo 3 – Passive gastrocnemious stretch

Passive gastrocnemious stretch

Photo 4 – Passive gastrocnemious stretch

arch stretching

Photo 5- Arch stretching Examples

Other Sever’s Disease Treatment Options

Treatments as well as preventing measures involve:

  • Limiting of the amount of time spent on intense activities
  • Wearing special shock-absorbent shoes
  • Using arch supports or heel cups (in case of splayfoot or high-arch situations)
  • Applying physiotherapies (ice, heat, ultrasound)
Our Advice

The above presented stretches can prevent or eliminate Sever’s disease by maintaining good flexibility and limiting the risk of an injury, particularly during the growth spurt. However, do not expect that to be achieved immediately – especially if the trainee is a child, who usually is more impatient when it comes to reaping the benefits of their hard work; in fact, the results are expected to become evident after a few weeks; luckily, sometimes, the disease subsides on its own after 1 or 2 months. In any case, the whole issue is, predominantly, a medical one, and therefore, health specialist’s advice should always be requested. Besides don’t forget to follow the Dos’ of our General Stretching Guide!

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Category: Stretches and Diseases

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