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Sever's injury (apophysitis calcanei) is considered to be the dominant cause of heel pain among children between 8 and 15 years. The traditional advice is to reduce and modify the level of physical activity. Recommended treatment in general is the same as for adults with Achilles tendon pain. The purpose of the study was to find out if insoles, of two different types, were effective in relieving heel pain in a group of boys (n=38) attending a Sports Medicine Clinic for heel pain diagnosed as Sever's injury. The type of insole was randomized, and self-assessed pain during physical activity in the treatment phase with insoles was compared with pain in the corresponding pre- and post-treatment phases without insoles. There were no other treatments added and the recommendations were to stay on the same activity level. All patients maintained their high level of physical activity throughout the study period. Significant pain reduction during physical activity when using insoles was found. Application of two different types of insoles without any immobilization, other treatment, or modification of sport activities results in significant pain relief in boys with Sever's injury.
Foot orthoses custom-made by vacuum forming on the non-load-bearing foot: Preliminary results in male children with calcaneal apophysitis (Sever’s disease)
Gabriel Gijon-Nogueron Encarnacion Cortes-Jeronimo Jose Antonio Cervera-Marin Raquel García-de-la-Peña Salomon Benhamu-Benhamu Alejandro Luque-Suarez
Prosthet Orthot Int April 12, 2013
Background and aim: To our knowledge, the technique of molding orthoses to the non-load-bearing foot is still not widely investigated. The aim of this work is, therefore, first, to describe an off-loading custom-made technique and, second, to explain how it can be specifically adapted to treat Sever’s disease.
Techniques: A technique of directly molding orthoses to the non-load-bearing foot by vacuum forming an insole to the foot fabricated with a combination of polyvinyl chloride and polyester resins, 30 Shore A hardness and 148 kg/m3 density polyethylene–ethylene-vinyl-alcohol, and a cushioning heel cup of 22 Shore A polyurethane, using a directly molding orthoses technique to the non-load-bearing foot by vacuum.
Discussion: Results show that this new technique could be a good alternative to traditional insoles in the management of Sever’s disease pain.
Clinical relevance Manufacturing the insole directly on the patient’s foot could lead to a better individual adaptation in general, and to manage Sever’s pain disease in particular.