Abstract
BackgroundPosterior Heel pain can present in children of 8 to 14 years, associated with or clinically diagnosed as Sever's disease, or calcaneal apophysitis. Presently, there are no comparative randomised studies evaluating treatment options for posterior heel pain in children with the clinical diagnosis of calcaneal apophysitis or Sever's disease. This study seeks to compare the clinical efficacy of some currently employed treatment options for the relief of disability and pain associated with posterior heel pain in children.MethodDesign: Factorial 2 × 2 randomised controlled trial with monthly follow-up for 3 months.Participants: Children with clinically diagnosed posterior heel pain possibly associated with calcaneal apophysitis/Sever's disease (n = 124).Interventions: Treatment factor 1 will be two types of shoe orthoses: a heel raise or prefabricated orthoses. Both of these interventions are widely available, mutually exclusive treatment approaches that are relatively low in cost. Treatment factor 2 will be a footwear prescription/replacement intervention involving a shoe with a firm heel counter, dual density EVA midsole and rear foot control. The alternate condition in this factor is no footwear prescription/replacement, with the participant wearing their current footwear.Outcomes: Oxford Foot and Ankle Questionnaire and the Faces pain scale.DiscussionThis will be a randomised trial to compare the efficacy of various treatment options for posterior heel pain in children that may be associated with calcaneal apophysitis also known as Sever's disease.Trial RegistrationTrial Number: ACTRN12609000696291Ethics Approval Southern Health: HREC Ref: 09271B
Highlights
Calcaneal apophysitis is an overuse syndrome thought to be caused by repetitive micro trauma due to increased traction of the calcaneo-achilles apophysis [1,2,3]
This will be a randomised trial to compare the efficacy of various treatment options for posterior heel pain in children that may be associated with calcaneal apophysitis known as Sever’s disease
Posterior heel pain reportedly associated with Calcaneal apophysitis has been reported to comprise 2%16% of musculoskeletal injuries in children [2,7,8]
Summary
Calcaneal apophysitis ( known as Sever’s disease [1]) is an overuse syndrome thought to be caused by repetitive micro trauma due to increased traction of the calcaneo-achilles apophysis [1,2,3]. This condition is characterised by pain experienced near the lower posterior aspect of the calcaneus in close proximity to the attachment of the Achilles tendon into the secondary growth plate of the calcaneus. There are no comparative randomised studies evaluating treatment options for posterior heel pain in children with the clinical diagnosis of calcaneal apophysitis or Sever’s disease. This study seeks to compare the clinical efficacy of some currently employed treatment options for the relief of disability and pain associated with posterior heel pain in children
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