Plantar Pressures in Severs Disease

NewsBot · Jan 17, 2011

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Plantar Pressures in Children With and Without Sever’s Disease
Ricardo Becerro de Bengoa Vallejo, Marta Elena Losa Iglesias, David Rodríguez Sanz, Juan Carlos Prados Frutos, Paloma Salvadores Fuentes and José López Chicharro
Journal of the American Podiatric Medical Association; Volume 101 Number 1 17-24 2011

Background: A case-control study was conducted to compare static plantar pressures and distribution of body weight across the two lower limbs, as well as the prevalence of gastrocnemius soleus equinus, in children with and without calcaneal apophysitis (Sever’s disease).

Methods: The participants were 54 boys enrolled in a soccer academy, of which eight were lost to follow-up. Twenty-two boys with unilateral Sever’s disease comprised the Sever’s disease group and 24 healthy boys constituted a control group. Plantar pressure data were collected using pedobarography, and gastrocnemius soleus equinus was assessed.

Results: Peak pressure and percentage of body weight supported were significantly higher in the symptomatic feet of the Sever’s disease group than in the asymptomatic feet of the Sever’s disease group and the control group. Every child in the Sever’s disease group had bilateral gastrocnemius equinus, while nearly all children in the control group had no equinus.

Conclusions: High plantar foot pressures are associated with Sever’s disease, although it is unclear whether they are a predisposing factor or a result of the condition. Gastrocnemius equinus may be a predisposing factor for Sever’s disease. Further research is needed to identify other factors involved in the disease and to better understand the factors that contribute to abnormal distribution of body weight in the lower limbs.
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Admin2 · Jan 18, 2011

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NewsBot · Feb 1, 2014

Static and Dynamic Plantar Pressure in Children With and Without Sever's Disease: A Case-Controlled Study.
de Bengoa Vallejo RB, Lola Iglesias ME, Rodriguez Sanz D.
Phys Ther. 2014 Jan 30

OBJECTIVE:
A case-controlled study was conducted to compare plantar pressures, plantar surface contact area, distribution of body weight across lower extremities, and the prevalence of gastrocnemius ankle equinus and gastrocnemius soleus ankle equinus causing decrease of ankle dorsiflexion range of motion in children with and without calcaneal apophysitis, also known as Sever's disease.
PATIENTS:
Participants included 56 male students enrolled in a soccer academy. Twenty-eight subjects were diagnosed with Sever's disease, and an equal number of healthy subjects constituted the control group.
METHODS:
Dynamic and static peak plantar pressure data, plantar surface contact area, and body weight distribution were assessed using pedobarography. Gastrocnemius and gastrocnemius soleus ankle dorsiflexion range of motion was assessed with a goniometer.
RESULTS:
Both maximum and average peak pressure and percent body weight supported in each heel were significantly higher in the symptomatic feet of the Sever's disease group compared to the control group. Twenty-six subjects with Sever's disease exhibited bilateral gastrocnemius ankle equinus, while only 8 subjects in the control group exhibited gastrocnemius ankle equinus.
CONCLUSIONS:
Higher heel plantar foot pressures in dynamic and static conditions are associated with Sever's disease. It is unclear, however, whether this is a predisposing factor contributing to the disease, or a result of the condition. Gastrocnemius ankle equinus may also be a predisposing factor for Sever's disease. Further research is needed to identify other biomechanical factors associated with the disease to enhance prevention and treatment strategies.
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NewsBot · Nov 26, 2018

Slow velocity of the center of pressure and high heel pressures may increase the risk of Sever’s disease: a case-control study
David Rodríguez-SanzView et al
BMC Pediatrics201818:357

Background
This study determined if the body mass index, dynamic plantar-pressures, plantar surface contact-area, velocity of the centre of pressure (COP), gastrocnemius equinus, and gastrocnemius soleus equines are related to calcaneal apophysitis (Sever’s disease) in athletic children.

Methods
This case-control study examined 106 boys enrolled in a soccer academy, including 53 with Sever’s disease and 53 age-matched healthy controls. The dynamic average and maximum peak plantar-pressures, plantar surface contact-area, and velocity of the COP were evaluated with a digital pressure sensor platform. Goniometry was used to measure the ankle dorsiflexion range of motion and thereby identify gastrocnemius equinus and gastrocnemius soleus equinus.

Results
Participants with Sever’s condition had significantly higher BMI and peak plantar-pressures (maximum and average) at the heel (Cohen’s d > 3 for pressures) than the controls. Those with Sever’s disease also had significantly slower velocity of the COP (Cohen’s d > 3). Boys with Sever’s disease were also 8 times more likely to have bilateral gastrocnemius equinus than disease controls.

Conclusions
High heel plantar pressure and low velocity of COP are related to Sever’s condition in boys, although it is not clear whether these factors predispose individuals to the disease or are consequences of the disease. Gastrocnemius ankle equinus could be a predisposing factor for Sever’s condition.
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NewsBot · Apr 26, 2019

VERTICAL GROUND REACTION FORCES DURING GAIT IN CHILDREN WITH AND WITHOUT CALCANEAL APOPHYSITIS
SimonMcSweeneyLloyd F.ReedScott C.Wearing
Gait & Posture; 25 April 2019

Highlights
•Loading patterns during gait were examined in children with calcaneal apophysitis.
•Vertical ground reaction force peaks did not differ to healthy children during gait.
•Peak regional plantar pressures beneath the foot did not differ to healthy children.
•Children with calcaneal apophysitis had a higher cadence, particularly when running.
•Higher cadence may be used to regulate loading patterns in calcaneal apophysitis.
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Background
Heightened vertical load beneath the foot has been anecdotally implicated in the development of activity-related heel pain of the calcaneal apophysis in children but is supported by limited evidence.

Research question
This study investigated whether vertical loading patterns during walking and running differed in children with and without calcaneal apophysitis.

Methods
Vertical ground reaction force, peak plantar pressure (forefoot, midfoot, heel) and temporospatial gait parameters (cadence, step length, stride, stance and swing phase durations) were determined in children with (n = 14) and without (n = 14) calcaneal apophysitis. Measures were acquired during barefoot walking and running at matched and self-selected speed using an instrumented treadmill, sampling at 120 Hz. Statistical comparisons between groups were made using repeated measure ANOVAs.

Results
There were no significant between group differences in vertical ground reaction force peaks or regional peak plantar pressures. However, when normalised to stature, cadence was significantly higher (≈ 5%) and step length shorter (≈ 5%) in children with calcaneal apophysitis than those without, but only during running (P <.05). Maximum pressure beneath the rearfoot during running was significantly correlated with self-reported pain in children with calcaneal apophysitis.

Significance
Peak vertical force and plantar pressures did not differ significantly in children with and without calcaneal apophysitis during walking or running. However, children with calcaneal apophysitis adopted a higher cadence than children without heel pain during during running. While the findings suggest that children with calcaneal apophysitis may alter their cadence to pressure beneath the heel and, hence pain, they also highlight the benefit of evaluating running rather than walking gait in children with calcaneal apophysitis.
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NewsBot · Apr 11, 2023

Characteristics of Pressure on the Apophysis in the Course of Paediatric Heel Pain—Preliminary Report
Aleksandra Bitenc-Jasiejko et al
Int. J. Environ. Res. Public Health 2023, 20(7), 5403

Increased pressure on the heel apophysis is often implicated as a cause of paediatric heel pain. However, there are few reports on the causes of the increased pressure and its origin. Therefore, the aim of this study was to analyse the distribution of pressure on the feet in children with heel pain. The study included 33 paediatric patients with non-traumatic heel pain, i.e., 24 boys (73%) and 9 girls (27%), aged on average 11.2 years (±3 years). Pedobarographic diagnostics proved a decrease in the pressure on the heels in relation to the ground and the transfer of the projection of the centre of gravity to the forefoot. While standing, the average contribution of the pressure on the heel was 0.52, SD = 0.14 in children with normal and reduced weight. In overweight children, the average pressure on the heel was higher (0.60, SD = 0.08), but the small number of children with this characteristic (n = 4) did not allow conclusions to be drawn in this area. Heel underload was also demonstrated during gait. However, the assessment of this aspect requires additional observational analyses in the field of propulsion and gait phases. The reduced pressure on the heel promotes apophysis traction, causing intracanal compression. Studies have shown that the causes of apophysis traction may be postural defects (in particular, forward inclination of body posture) and overpronation of the foot, or defects in the metatarsal area.
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