eMedicine Specialties > Orthopedic Surgery > Foot & Ankle

Sever Disease: Follow-up

Author: Mark A Noffsinger, MD, Clinical Instructor, Department of Orthopedic Surgery, Michigan State College of Human Medicine; Medical Director, Deptartment of Orthopedic Surgery, Bronson Methodist Hospital, Consulting Staff, Kalamazoo Orthopedic Clinic
Contributor Information and Disclosures

Updated: Apr 9, 2009

Follow-up

Deterrence/Prevention:

  • To prevent recurrence, patients, parents, coaches, and trainers should be instructed regarding a good preexercise stretching program for the child. Early in the season, encouragement should be given for a preseason conditioning and stretching program. Coaches and trainers should be educated about recognition of the clinical symptoms so they are able to initiate early protective measures and seek medical referral when necessary.

Complications:

  • No known complication exists from failure to make the correct diagnosis because the disease is self-limited.

Prognosis:

  • Sever disease is a self-limited condition.

Patient Education:

Miscellaneous

Medicolegal Pitfalls

  • Failure to instruct players, parents, coaches and trainers regarding limiting the patient's activity and proper preexercise and postexercise stretching can lead to prolonged symptoms and further limitation of performance.
  • Failure to instruct patients and parents that continual pain, significant swelling or redness, and fever are not signs of Sever disease and, therefore, require further evaluation could result in failure to diagnose a condition with much more serious long-term consequences.
 


More on Sever Disease

Overview: Sever Disease
Differential Diagnoses & Workup: Sever Disease
Treatment & Medication: Sever Disease
Follow-up: Sever Disease
Multimedia: Sever Disease
References
Further Reading
[ CLOSE WINDOW ]

References

  1. Pappas AM. The osteochondroses. Pediatr Clin North Am. Aug 1967;14(3):549-70. [Medline].

  2. Katz JF. Nonarticular Osteochondroses. Clinical Orthopaedics and Related Research. 1981;158:70.

  3. Pizzutillo PD, Sullivan JA, Grana WA. Osteochondroses, Chapter in The Pediatric Athlete, American Academy of Orthopaedic Surgeons Seminar, Oklahoma City Oklahoma, November 1998.

  4. Roy DR. Accessory Navicular and Osteochodroses of the Foot and Ankle in the Child and Adolescent. Foot and Ankle Clinics. Philadelphia: WB Saunders;1998.

  5. Scharfbillig RW, Jones S, Scutter SD. Sever's disease: what does the literature really tell us?. J Am Podiatr Med Assoc. May-Jun 2008;98(3):212-23. [Medline].

  6. Lau LL, Mahadev A, Hui JH. Common lower limb sport-related overuse injuries in young athletes. Ann Acad Med Singapore. Apr 2008;37(4):315-9. [Medline].

  7. Malanga GA, Ramirez-Del Toro JA. Common injuries of the foot and ankle in the child and adolescent athlete. Phys Med Rehabil Clin N Am. May 2008;19(2):347-71, ix. [Medline].

  8. Weiner DS, Morscher M, Dicintio MS. Calcaneal apophysitis: simple diagnosis, simpler treatment. J Fam Pract. May 2007;56(5):352-5. [Medline].

  9. Clemow C, Pope B, Woodall HE. Tools to speed your heel pain diagnosis. J Fam Pract. Nov 2008;57(11):714-23. [Medline].

  10. Irving DB, Cook JL, Young MA, Menz HB. Impact of chronic plantar heel pain on health-related quality of life. J Am Podiatr Med Assoc. Jul-Aug 2008;98(4):283-9. [Medline].

  11. Hendrix CL. Calcaneal apophysitis (Sever disease). Clin Podiatr Med Surg. Jan 2005;22(1):55-62, vi. [Medline].

  12. Turek SL. Orthopaedics: Principles and Their Application. JB Lippincott Company:1984: 1474.

  13. Sever JW. Apophysitis of the Os Calcis. New York Medical Journal. 1912;95:1025-1029.

  14. Sever JW. Apophysitis of the Os Calcis. American Journal of Orthopaedics. 1917;15:659.

  15. Micheli LJ, Ireland ML. Prevention and management of calcaneal apophysitis in children: an overuse syndrome. J Pediatr Orthop. Jan-Feb 1987;7(1):34-8. [Medline].

  16. Brenner JS. Overuse injuries, overtraining, and burnout in child and adolescent athletes. Pediatrics. Jun 2007;119(6):1242-5. [Medline].

[ CLOSE WINDOW ]

Keywords

Sever disease, Sever's disease, calcaneal apophysitis, calcaneal epiphysitis, traction apophysitis, Achilles tendon pain, heel pain

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Mark A Noffsinger, MD, Clinical Instructor, Department of Orthopedic Surgery, Michigan State College of Human Medicine; Medical Director, Deptartment of Orthopedic Surgery, Bronson Methodist Hospital, Consulting Staff, Kalamazoo Orthopedic Clinic
Mark A Noffsinger, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Orthopaedic Medicine, American College of Physician Executives, American Fracture Association, American Medical Association, American Medical Directors Association, Christian Medical & Dental Society, Indiana State Medical Association, International Society on Thrombosis and Haemostasis, Michigan State Medical Society, Mid-America Orthopaedic Association, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

James K DeOrio, MD, Director of Foot and Ankle Fellowship Program, Assistant Professor of Orthopedic Surgery, Orthopedic Surgery, St Lukes Hospital, Jacksonville, Florida
James K DeOrio, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Foot and Ankle Society, Florida Medical Association, and German Society of Neurology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Shepard R Hurwitz, MD, Executive Director, American Board of Orthopaedic Surgery
Shepard R Hurwitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for the Advancement of Science, American College of Rheumatology, American College of Sports Medicine, American College of Surgeons, American Diabetes Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Association for the Advancement of Automotive Medicine, Eastern Orthopaedic Association, Orthopaedic Research Society, Orthopaedic Trauma Association, and Southern Orthopaedic Association
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Jason H Calhoun, MD, FAAOS, Chairman, J Vernon Luck Distinguished Professor, Department of Orthopedic Surgery, University of Missouri
Jason H Calhoun, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, and American Orthopaedic Foot and Ankle Society
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.