Morbus Sever
ANATOMY
The pain symptoms of this so-called 'Morbus Sever' are located where the Achilles tendon is attached to the growth plate of the heel bone. This growth plate
is softer than bone and must grow in different directions during the growth phase. If there is too great a tensile stress of, for example, the Achilles tendon, on the growth plate, microcracks can occur with inflammatory symptoms. The complaints occur during periods of growth. The complaints are mainly at the beginning of the season or when a change is made to a different surface, such as from outside (field) to inside (room). Fast sprint movements, short braking movements and jumping often cause more complaints.
In America, the condition is also called 'September heel' because many children suffer from it when they go back to school after the summer and start training for the various sports teams. The complaints are also triggered if the surface on which
sports are changed, for example at the time of the transition from summer to winter training (indoor). Foot deformities (such as flat or hollow feet), poor footwear, tight or short calf muscles, weak ankle muscles and overuse can also be factors.
WHAT ARE THE CAUSES?
The causes for an increased load on the growth plate of the heel can be:
• Abnormal foot position, such as inward tilting foot;
• Grow;
• High sports load;
• High sprint and jump load;
• Bad (sports) footwear;
• Little cushioning in the shoe or surface; • Instability of the foot.
WHAT ARE THE (PAIN) COMPLAINTS?
Complaints that arise are pain around the heel, sometimes with radiation to the arch of the foot or in the calf and are therefore often confused with Achilles tendon complaints.
The complaints mainly manifested themselves during and immediately after
the sport. Sports can be started without pain and the pain can come on very acutely, especially after starting a sprint or with a jump load. The pain can then be very severe so that they have to leave the sports field 'limping'. These severe complaints often disappear quickly, the next day or after 2 days. In a few cases, the complaints extend, causing
the pain is also present in everyday life. The pain may be accompanied by redness and swelling at the back of the heel and Achilles tendon.
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WHAT CAN WE MEAN FOR YOU?
In principle, the Morbus Sever is 'self-limiting', which means that the complaints will pass by themselves when the child has grown and the growth plate has ossified. In the meantime, however, it is often possible to let children exercise without pain by using:
shoe advice
The sports podiatrist can give specific (sports) shoe advice.Insoles for everyday use and/or sports
To correct the foot position and gait pattern, thus reducing the strain on the growth plate and increasing the load capacity.
Usually the soles only have to be worn with the sports load. Sometimes this is not possible and the soles are also worn during the day, for example during gymnastics or if the complaints are also present in daily life. The therapy will be necessary until the growth plate is fully grown and the heel can therefore bear the load.
Tax adjustment
If necessary, a look can be made, in consultation with the trainer/coach, to reduce the pain-causing load. This includes less jump/sprint load.
in pain
cooling with a cold pack;
Pain-relieving/anti-inflammatory
cream, eg Traumeel.