Arch taping as a symptomatic treatment in patients with Sever's disease: A multiple case series

Abstract

Background Sever's disease, is a musculoskeletal condition occurring in adolescence that symptomatically manifests as posterior heel pain during ambulation. Often participation in physical activity is severely limited resulting in frustration for children and parents alike. Conservative treatment options have included rest, abstinence from athletic activity, heel lifts, foot orthotic devices, ice, and calf-stretching exercise. The authors are proposing arch taping as an additional viable treatment option for controlling heel pain during athletic and other weight-bearing activities in patients with Sever's disease. Objective To assess the immediate impact of arch taping in controlling heel pain during ambulation in a group of subjects with Sever's disease and to discuss possible biomechanical explanations. Methods and measures Eleven subjects diagnosed with Sever's disease with a history of posterior heel pain were evaluated and treated by three different therapists in three different regions in the USA. Level of perceived pain during ambulation was reported before and immediately after arch tape application. The Wilcoxon Signed Ranks Test was utilized to assess pain reduction with significance set at p < 0.05 level and effect size was determined with Cliff's delta statistic. Outcomes Each subject reported an immediate reduction in heel pain during ambulation with arch taping. The median reduction in pain was 5 levels. Wilcoxon's statistic was significant with p = 0.001 and Cliff's delta revealed a value of 0.97 indicating a large pain reduction effect with arch taping. Conclusions The arch taping technique applied in this case series was effective in the immediate reduction of posterior heel pain during ambulation and allowed an early return to sports activities for those involved in athletics. This technique could be considered an additional treatment option for others with similar clinical presentations. Possible biomechanical explanations may relate to a windlass effect provided through the taping technique.