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Severs disease treatment

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Robertisaacs, Feb 8, 2008.

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    I wish to tap the infinite wisdom of the community.

    I have recently become aware of the case of a young lady of 8 yo who presents with a severe case of severs. She cannot "go out" at playtime much less do PE and her quality of life is being severely affected.

    Her Podiatrist has (i am told) put her in a night splint to dorsiflex the foot to 90 degrees (which is the full available dorsiflexion).

    This is not a treatment i have come across before and i am a little confused by it. I would have imagined dorsiflexing the foot will apply more tensile stress on the growth plate and impeed healing.

    1. Is there anyone who can explain this technique to me?

    2. If you use any AFO type devices for severs what have you found to be most effective?

    3. What treatments have you found to be most effective.

  2. Admin2

    Admin2 Administrator Staff Member

  3. bkelly11

    bkelly11 Active Member

    I seen a young girl recently who presented with severes disease.


    played a lot of sport on hard surfaces, netball, basketball and tennis

    bio exam revealed fully comp R/F varus.

    poor footwear.

    Having never treated severs before i went to the uni notes. (never came accross AFOs in my search for treatments!)

    My experience

    I got the patient into a good pair of cross training shoes with good cushioned soles i then used off the shelf orthotics with a 4mm heel lift with much success.

    i recently reviewed her and she is pain free.

    to be honest my idea or thinking was that i was reducing excessive pronation and decreasing tension on the achillies tendon. however, i have recently seen posts on this site claiming that heel lifts do not decrease tension on the achillies tendon and may actually increase the load.

    Sharon J. Dixon; David G. Kerwin: The Influence of Heel Lift Manipulation on Achilles Tendon Loading in Running. JAB, 14(4), November 1998

    i guess the heel raise in increasing cushioning/shock attenuation.

    In this case i believe footwear played a major role in relieving her symptoms.
    Last edited: Feb 8, 2008
  4. Craig Payne

    Craig Payne Moderator

    I have never heard of that before, nor do I necessarily see a need for it. I can not understand the rationale for it.
  5. DSP

    DSP Active Member

    Hi Robert,

    The biggest challenge I face in pts with severs disease is compliance. Often, the children I treat with this condition want to run around in thongs/barefoot on hard surfaces which makes it difficult to treat. Despite this though, stretching, ice, activity modification, orthotics in conjunction with heel raises and the correct footwear help wonderfully if adhered to properly.

    I don't understand the logic behind the use of a night splint. The only reason I can think of is that the podiatrist who prescribed the night splint must believe that the condition is more to do with a tight gastrocnemius-soleus-achilles tendon complex which is certainly not the case. I've tried searching the literature to see if their is any evidence but have found nothing thus far.

    In addition, making sure that both the child and parent are educated is important too. I've had some blank looks before when trying to explain what's happening. I routinely use previous x-ray examples to demonstrate the actual problem. I have found this to be very helpful.



  6. Robert:

    Contrary to the others, using a plantar fasciitis night splint to treat Sever's disease does make sense to me, but using a night splint would not be my preferred method of treatment for this disease entity.

    I treat many cases of Sever's disease. Most cases of Sever's disease respond well to reducing the tensile force on the Achilles tendon so that the shearing stress is reduced on the calcaneal apophysis. I first of all give them 1/4" (6 mm) heel lifts to wear at all times, have them do gastrocnemius and soleus stretches 2-3 times per day, have them ice the posterior heel 20 minutes twice a day, avoid barefoot activities and reduce their running activities initially. If they do not respond to this protocol, then I will try an over-the-counter foot orthosis or custom foot orthosis and may have them totally cut out all running activities for at least 2 weeks. In more extreme cases, I will put them into a below-knee fiberglass cast for 3-6 weeks which works quite well for the more severe cases of Sever's disease.

    I have frequently used plantar fasciitis night splints in treating athletes with chronic Achilles tendinitis which does work, in some cases, quite well. The theory is that a low level ankle joint dorsiflexion moment over time will place enough tensile force on the gastrocnemius-soleus-Achilles tendon (GSAT) complex to prevent accommodative shortening of the GSAT at night while the patient sleeps so that there will be less tensile force acting within the Achilles tendon during athletic activities during the day. The same mechanics should hold true for using a night splint in Sever's disease, but I have never used night splints in treating Sever's disease. Using a night splint certainly can't hurt the patient. Maybe I'll give a night splint a try on the next patient I have with Sever's disease.

    Considering the known time-dependent viscoelastic properties of ligaments and tendons such as stress-relaxation, where tendons and ligaments experience a decrease in tensile force over time when stretched to a given length, and creep, were tendons and ligaments stretch further over time when subjected to a given tensile loading force, why wouldn't a night splint reduce the tensile force on the Achilles tendon also? If these splints work for plantar fasciitis, they should work for Sever's disease, since there is a direct relationship between Achilles tendon tensile force and plantar fascial tensile force during weightbearing activities (Carlson RE, Fleming LL, Hutton WC: The biomechanical relationship between the tendoachilles, plantar fascia and metatarsophalangeal joint dorsiflexion angle. Foot Ankle Intl., 21:18-25, 2000; Erdimir A, Hamel AJ, Fauth AR, Piazza SJ, Sharkey NA: Dynamic loading of the plantar aponeurosis in walking. JBJS, 86A:546-552, 2004).

    Here is some additional reading for those of you who want to learn more about the time-dependent viscoelastic properties of ligaments and tendons.












    Last edited: Feb 9, 2008
  7. yvonnespod

    yvonnespod Member

    Has anyone heard or used OSCON tablets ?? yvonnespod
  8. Craig Payne

    Craig Payne Moderator

    It a vitamin e derivative. How will something like that come close to helping Severs - a mechanical problem? Put it in the snake oil category.
  9. Stanley

    Stanley Well-Known Member

    I treat Sever’s disease by first making a pair of orthoses, and if there is equinus, I will treat that also.
    The whole idea is to decrease compression forces at the metaphysis. The tension from the plantar fascia is a distal directed vector, and the tension from the Achilles is a vertical vector. The combined vector is angled upwards and distally, so as to cause a compression of the metaphysis.
  10. Mark Egan

    Mark Egan Active Member

    I have found with the drought here in Australia that there has been an increase in sever's issues is this something that others are finding as well.

    For football players i.e. soccer and rugby I also advise them to stop wearing the boots for training and only wear them for games.

    Also any thoughts on the latest offering from ASICS football boots with 10mm heel gradient ?
  11. Stanley

    Stanley Well-Known Member


    It would seem that because of the drought the ground is harder, so the spikes do not penetrate the gound as well. That means that the heel and forefoot are being raised.
    Put the shoe on a hard level surface and push down on the shank from the inside of the boot. If the shank is not rigid, then this is your problem. You can place some material in the arch area to mimic the shape of the deformation, or under the orthosis if the patient already has one
    The real answer would be if Asics were to put another spike in the middle of the arch.


  12. Adrian Misseri

    Adrian Misseri Active Member

    G'day all,

    Interesting idea using a night splint for the management of Sever's. I can undertand the rationalle, given the relationship between equinus and traction on the growth plate (1). I always make a point of my Sever's management to include a stretching program to reduce the constant traction on the growth plate by lengthening the achillies, and can see how one could reason that night splinting can assist with stretching. However... we must remember that Sever's is an acute apopsitis injury due to trauma and traction, with inflammation, that may lead to avascular necrosis to the growth plate(2). It is important to attempt to lengthen the achillies to reduce the pull on the growth plate, but my fear with a constant protracted stretch for several hours each night will just contribute to the problem, especially in cases when there is signifant avascular necrosis, and thus a reduction in the overall tensile strength of what is already a stretched growth plate. I also tend to use 9mm PPT poron heel cushions in the absence of other mechanical abnormalities with good success. Failure to respond to these usually sees my patients in orthoses, but as this is often a developmental disorder, they will generally outgrow the Sever's in time.


    (1) Szames S et.al. 1990 "Sever's disease and its relationship to equinus: a statistical analysis" Clin Podiatr Med Surg Apr 7:(2) pp 377-84
    (2)Hendrix C. 2005 "Calcaneal Apopysitis" Clin Podiatr Med Surg Jan 22: (1) pp. 55-62
  13. Scorpio622

    Scorpio622 Active Member


    I see quite a bit of Severs. With "severe" cases where the child comes in limping with the aforementioned quality of life issues, I recommend a short leg cast for 3-4 weeks. In uber-compliant kids and fracture boot may suffice- but most will remove this frequently. After casting, proceed with what has been mentioned- stretching, heel lifts, ice, and perhaps physio referral.

  14. Stanley

    Stanley Well-Known Member


    How does a night splint cause stetching of the gastroc, if the patent bends their knee when sleeping?


  15. If the patient keeps their knees flexed all night, then the night splint would mostly stretch the soleus and Achilles tendon. However, if they keep their knees extended, the night splint would mostly stretch the gastrocnemius and Achilles tendon. That is why I very cleary stated in my posting the following: "The theory is that a low level ankle joint dorsiflexion moment over time will place enough tensile force on the gastrocnemius-soleus-Achilles tendon (GSAT) complex to prevent accommodative shortening of the GSAT at night while the patient sleeps so that there will be less tensile force acting within the Achilles tendon during athletic activities during the day."
  16. Stanley

    Stanley Well-Known Member


    The muscle we are concerned with is the tightest structure of the gastrocnemius-soleus-Achilles tendon. I find that this is the gastrocnemius, as dorsiflexion increases in the ankle with the knee flexed, not with the knee extended.
    As far as people sleeping with the knee extended, unless they sleep on their back this will not happen. It is recommende that people sleeping on their back put a pillow under their knees to reduce the stress on their back (this also flexes the knee). http://www.romow.com/health-blog/different-sleeping-positions-what-is-the-best-position-for-you/
    Furthermore, my patients do not tolerate night splints that are tight enough to cause stetching.
    You obviously get different results. How exactly do you have the patients apply their night splints?
  17. deco

    deco Active Member


    I use night AFO's to help adults and children who present with tight Gastrocs secondary to a variety of underlying neurological problems. Although the AFO's are primarily designed to be worn at night time I advise patients to wear them for an hour or 2 during the day and encourage both walking and long leg sitting (while watching TV). Using a dorsiflexion assist "Tamarack" ankle joint can be useful and will provide a continuous dorsiflexion stretch.

    A leg gaiter can also be used at night time to resist knee flexion and ensure that the Gastroc remains stretched.

    With suitable wearing guidlines compliance and tolerance with these devices never seems to be an issue,


  18. Stanley

    Stanley Well-Known Member


    What you say makes sense. However, most podiatrists do not use leg gaiters, and they still get good results. It would make one think that possibly there is another mechanism.


  19. NewsBot

    NewsBot The Admin that posts the news.

    Sever’s Disease: What Does the Literature Really Tell Us?
    Rolf W. Scharfbillig, Sara Jones and Sheila D. Scutter
    Journal of the American Podiatric Medical Association; Volume 98 Number 3 212-223 2008
  20. Gary Nelson

    Gary Nelson Member

    I noticed your "snake oil" comment about Oscon from a couple of years ago. It told me two things:

    1. You have never utilized it.

    2. You have no problem passing judgement and issuing opinions on techniques that you know little or nothing about!

    I'm sorry if that seems harsh, but I have employed Oscon in many thousands of cases of Severs and Osgood-Schlatter and Severs disease SUCESSFULLY!

    If you are willing to learn what it is, as well as how and why it works just email me with any questions. I can also give you users in your area.

    Gary Nelson
    Pediatric Sports Therapy

  21. Gary:

    You wouldn't happen to sell Oscon for a profit, would you?? If you are coming onto this site for the first time to tell how great a product is, and don't have any financial interest in the product, then that is one thing. However, we already have enough individuals who sell a certain product, then come onto this website to tell us how great it is, and then offer us a website we can purchase it....and help line their wallets for them.

    Which one is it Gary? Do you sell Oscon or not?? My snake oil sensor alarm is starting to go off...:butcher:

    By the way, Gary, you may not be harsh...but I am.:boxing::rolleyes:
    Last edited: Jun 9, 2008
  22. Craig Payne

    Craig Payne Moderator

    You right I have not used it and at this stage have no plans to start sing it (or buying it from your website).
    Please provide the references to randomised controlled clinical trials that it it better than placebo for Severs. Please provide references to credible pathophysiological mechanism by which a vitamin can affect the mechanical nature of Severs.
    You do realise that by making such a claim without the references, you are just confirming the snake oil nature of this product (there are planty of tutorials on the web on how to recgnise snake oil, eg Spotting Quackery Online; Peddlers, Scammers, and Snake Oil... oh my!; Snake Oil Tutorial). You also help confirm the snake oil perception by posting here with the sorts of comments that you did and not declaring your vested finanical interest in selling the product.

    I will be one of the first to use any product or method when the clinical research evidence supports it. In the absence of evidence I use methods or products I am comfortable using then when there is a clear pathphysiological or pathomechanical rationale to them, that is theorectical coherent and biologically plausible. I can see neither for this product.
  23. DaVinci

    DaVinci Well-Known Member

    How any times have we been around this track?
  24. Gary Nelson

    Gary Nelson Member

    1. I am not asking you to use it or buy it. I only would like a fair, unbiased opinion based on fact, not on unsubstantiated prejudice. I do distribute the product, but I was not aware that profit was forbidden, or even a valid basis for criticism.

    2. I'll try to make it simple for you. Severs is only initiated by trauma at the tendon's insertion point. The reason it does not heal is because of a persistent inflammatory condition at the site. Osgood-Schlatter is a similar situation.
    The inflammation is caused by Reactive Oxygen Species and Lipid Peroxyl Radicals, and their subsequent propagation. Remove the inflammatory situation and the injury heals. The University of Southern California's School of Pharmacy published the following explanation of the action of the ingredients in Oscon:

    Reaction of antioxidant compounds with oxyradical species
    Reactive oxygen species (ROS) are represented by activated forms of oxygen (oxyradicals or monovalent reduction products of oxygen) and organic radicals and peroxides that are produced by reaction with oxyradicals. Figure 9 (33 Kb) shows the stages for monovalent reduction of oxygen, indicating the oxyradicals (O2-., superoxide radical; .OH, hydroxyl radical) and ROS (H2O2). Also shown at the bottom are the various common biological sources for these ROS. These ROS can oxidize cell proteins (particularly sulfhydryl-rich proteins) leading to inactivation. They also readily react with and oxidize unsaturated lipids. This process is facilitated by transition metals such as iron and copper, or by heme proteins where the metal in these heme proteins are oxidized to hypervalent states that readily attack unsaturated lipids.
    Figure 10 describes the steps involved in the oxidation of a typical unsaturated fatty acid, linoleic acid. The first product is a lipid peroxyl radical, derived from oxygen addition to the lipid alkyl radical intermediate which arises by reaction of the lipid with the ROS or hypervalent metal. The peroxyl radical rapidly reacts with another lipid to generate a new peroxyl radical and a lipid hydroperoxide. This reaction proceeds at a rate constant of 106 moles/sec and represents the kinetic stages for the propagation of lipid peroxidation. By these reactions lipid hydroperoxides accumulate, leading to the deterioration of the lipid and formation of organic ROS that account for many of the biological effects noted above.

    Inhibition of lipid peroxidation by specific antioxidants: the special role of vitamin E and selenium

    It is at this stage that vitamin E and related antioxidants exert an inhibitory effect. By reacting with the lipid peroxyl radical at a rate constant faster than reactions of lipid peroxyl radical with other lipids (ie. 109 moles/sec) vitamin E has a strong kinetic advantage in suppressing the propagation of lipid peroxidation. Moreover, the limited formation of hydroperoxides by reaction with vitamin E is readily managed by reactions with peroxidases, key among which are the selenium containing glutathione peroxidases which convert the potentially reactive lipid hydroperoxides to nonreactive lipid alcohols.

    I myself am more interested in the truth than in any "randomised controlled clinical trials ", but I will make you this offer:

    I will provide you with whatever quantity of Oscon that you feel is necessary for you yourself to adequately test it and form your own substantiated opinion of the product. In the process I am sure you will help relieve over 90% of the non-placebo group, as well as gain knowledge that will help many others.
    What do you have to lose? You can then form a valid opinion based on the facts, rather than on outside or prejudicial influences. I am aware that there are "snake-oil' salesment on the internet. I am not one of them. I had Severs and Osgood-Schlatter myself some 50+ years ago. I fully understand the frustration and recall the pain that accompanies such conditions.

    Here are some responses from Australia:
    Hi Gary, My son Tim began to take OSCON about 10 days ago. When I ordered OSCON my husband said "Here we go, you've fallen for another scam!" But I didn't care because Tim, who is a keen runner and footballer, needed something. We are all amazed. The pain is gone, though as your email says the bump is still slightly tender. Thank you, I will be ordering another course to be certain of a good recovery.
    Jenny M., Lambton, Australia

    Dear Gary
    Thanks for your reply. Oscon is nothing short of a miracle. My daughter felt an improvement on day one of taking it. On day 2 she was pain free. My husband can't believe it. In fact, when I had first showed him the Oscon website he suggested that he could sit down and write all those testimonies in an afternoon.
    Although I did find one discrepancy in the testimonies, I felt that they had the ring of truth about them and I had no doubt that Oscon would work. I am very glad that you included all those testimonies on your website because I would not have bought the Oscon (and my daughter wouldn't be where she is now) if I hadn't read all the testimonies. When I first saw Oscon, I immediately discounted it as something to try. But as I read through the testimonies, I realised that here was something that could work. It is as amazing as an antibiotic - the patient is immediately better when they take it!! (Note: Recovery times do vary. It usually takes more than one day)
    Oscon has saved our family from months of stress and misery. My daughter's Olympic dreams may have ended. There is no way that my daughter could have coped with the workload expected by the High Performance coaches with the amount of pain she was in. She would have been absolutely devastated.
    Thank you for your truly amazing, remarkable product.
    Judy B., Mudgeeraba, Queensland, Australia


    I wish to give you some feedback.

    My 13 yo daughter had Severs and plays at an elite level of tennis and predominantly on hard courts. She could not train for extended periods without severe pain. She has been taking the Oscon for a month now and the pain is gone. We have also reduced the number of hours on court, ice the heel after play and she has been working regularly with a physio. We are all very pleased with the outcome.
    From your notes below, it seems that we could reduce the dosage to 1 per day.
    I look forward to your further advice.

    Philip K., Buderim, Australia

    Dear Gary,

    My 13 year old boy is extremely talented in track & field, and has been frustrated with not been able to compete this season due to Severs. After three weeks of taking Oscon, and seeing a physiotherapist twice a week, he is almost pain free. He has been able to run sprints and hurdles, with hardly any pain, and has just been selected in the State team, to compete in the Nationals in hurdles. I am so glad I came across your website, and in desperation, decided to give Oscon a go. My son is just about to finish his first bottle, and I have ordered another one, so he will be able to compete in the Nationals without any problems. I just wanted to say thank you very much, and you may use this on your website.
    Kind Regards,

    Raine Mitchell, (Melbourne, Australia)

    I have 90 pages of such testimonials. If you want to see more, I will gladly share them.

    By the way, I did not post a website to purchase it did I? It may have been in my profile though.

    Please do not hold such a negative opinion without justification, and I hope that you take me up on my offer to run your own trial. Not to make money hand over fist (or should I more aptly say "head over heels"?), but to help the many thousands of young athletes that needlessly suffer for months with apophyseal injuries like Severs.

    Oscon is theoretically coherent and biologically plausible. Why not find out for yourself?

    Gary Nelson
    Last edited: Jun 9, 2008
  25. CraigT

    CraigT Well-Known Member

    Hi Gary,
    Do you have a reference for the above statements?
    I am keeping an open mind, but I have similarly fantastic results by decreasing the mechanical load on on the tendo-achilles insertion (as I am sure most of the contributors on this forum do- it is not something I regard as a challenging problem...)
    Interested that you also claim brilliant results also with Osgood-schlatters. This is regarded by some as an indicator of a high risk of patella tendon pathology later in life... can you fix that too? Then I will be impressed...
  26. Gary Nelson

    Gary Nelson Member

    Inflammation is generally regarded as a given. See http://www.footpaininfo.com/seversdisease.html

    In my experience Severs is eliminated by Oscon within 2-8 weeks. Without it 6 months is not uncommon. Osgood-Schlatter is controlled in about the same time with Oscon. Without it 18 months seems to be the "average", and I have seen it persist for 4-6 years!!

    Most health professionals do not regard either condition as compelling problems, maybe because both are considered to be self limiting. However for the youngster with these conditions they can be a considerable hardship.

    Some researchers feel that up to 60% of those who had Osgood-Schlatter as a youth may have some discomfort as adults. See: http://www.intelihealth.com/IH/ihtIH/WS/9339/31201.html (Near bottom of page.)

    I myself avoid kneeling on hard surfaces, as I have the "souvenir" osteophytes on both tibial tuberosities! Also there is a genetic component. It does run in families, and a child that has had Severs is more likely to develop OSD that one that did not have it. "Same church, different pew". By the way, Ischial Apophysitis is similar, although rarer, and can be treated the same way.

    Here is a sports medicine Podiatrist who can tell you of his own successful experiences with Oscon:

    Name: Dr. Todd Flitton, DPM
    Address: 507 Anita Dr.
    City, St. ZIP: Kaysville, Utah 84037
    Country: UnitedStates
    Telephone: 8017734840
    E-Mail Address: my234pr@aol.com

    Need a sample?

    Best regards,
    Gary Nelson
    Last edited: Jun 9, 2008
  27. CraigT

    CraigT Well-Known Member

    Pardon my ignorance, but is this different from other types of inflammation? Do you have any reference differentiating this from other inflammatory problems in the body?

    Not this little black duck.

    In my experience it is 1-2 weeks with control of mechanical overload.

    Unfortunately (or fortunately...?) Severs is not a problem I have seen much of in Qatar up to this point so no need for a sample at this stage. This may be due to most of the local population not knowing what a Sports Podiatrist is (yet!) and not seeking treatment. If I find that I am having a lot of these cases, then perhaps I will run a trial for you. Otherwise I would suggest a double blind randomised control trial run in conjunction with a University like La Trobe (which is where Craig Payne is( and me originally))... They did do this a few years back to test claims that wheat grass extract cured plantar fasciitis (it did no better than placebo).
  28. Craig Payne

    Craig Payne Moderator

    Where are you getting your information from? Severs has nothing to do with the tendon's insertion. Published studies using MRI have shown the pathology to be in the metaphysis - thats a long way from the tendon insertion. Do you have some published research showing otherwise? I did not know Severs was even an inflammatory process. Do you have a published reference to support that claim? (Osgood Schlatters is a different beast and is an inflammatory process)
    You need to follow those links on how to recognise snake oil. You just proved again what I was saying by making all the claims you do.
  29. Gary Nelson

    Gary Nelson Member

    Since you are the self-professed "Professor of Life, The Universe and Everything" I expected you to be a "tough sell'. However I stand by my experiences in treating Severs and Osgood-Schlatter.

    Severs is initiated by an injury, followed by inflammation and subsequent edema.

    Q. Where are you getting your information from? A. Since I have researched this problem for over 20 years, I have dozens, if not hundreds of sources.
    One is: http://www.med.umich.edu/1libr/sma/sma_calcapop_sma.htm

    Q. Severs has nothing to do with the tendon's insertion. Published studies using MRI have shown the pathology to be in the metaphysis - thats a long way from the tendon insertion. Do you have some published research showing otherwise?
    A. See: http://www.hawaii.edu/medicine/pediatrics/pemxray/v1c20.html

    I did not know Severs was even an inflammatory process. Do you have a published reference to support that claim? (Osgood Schlatters is a different beast and is an inflammatory process)

    Severs and Osgood-Schlatter are almost identical conditions.
    From the US National Institutes of Health: http://www.ncbi.nlm.nih.gov/pubmed/8900359
    Question: Why are anti-inflammatories suggested?
    Answer: To treat the inflammation.
    Also see: http://www.fpnotebook.com/Ortho/Ankle/SvrsDs.htm

    An inflammatory process inhibits rapid healing in both conditions.

    More information: http://www.ncbi.nlm.nih.gov/pubmed/7762480

    In some ways you remind me of my father. Two of his favorite statements were:

    "My mind is made up, don't confuse me with the facts."
    and "Even if it was good, I wouldn't like it."

    But let's not get caught up in the minutiae. Either Oscon works or it does not. I know it works, are you willing to test it?

    You are a DPM, and I am a biochemist. It is natural that we would follow different paths to different destinations. I do not reject your methods because they are different than mine, and would hope that you would be a little more open to other modalities. If I were trying to "steal" someone's hard earned money I would likely be trying to sell something that made them skinnier, richer, sexier or enlarged certain parts of their anatomy. I am a lot more altruistic than that, and I had hoped that you would be as tolerant of my efforts as I am of yours.

    Gary Nelson
  30. Gary Nelson

    Gary Nelson Member

    Inflammation is inflammation. The exact chemistry may vary, but the basics are the same. So does Oscon work in other types of inflammation? I would be the first to say that it is not a panacea. But I have received reports from people with various problems such as shin splints, rib fractures, knee replacement and others who are convinced that it made a huge difference in their cases. I do not however feel comfortable recommending it for conditions where I do not have hundreds of valid reports to rely upon.

    I agree that there is more "sizzle than steak" in wheatgrass.

    Now if someone would consent to a double blind randomised control trial I would be ecstatic. However it seems that almost all current trials are being done by drug companies who pay huge sums to their researchers. True?
    I have yet to find anyone who does such work for the sake of science. I hope to someday soon. Maybe someone in this arena could point me in the proper direction?
    Keep in mind that I am just one small company that has the objective of helping young athletes overcome their conditions as rapidly and economically as possible. I have been lucky enough to have enough good DNA (MENSA qualified), and persistent (stubborn swede) enough to come up with an honestly valid tool to help in cases of apophyseal injury.

    Best regards,
    Gary Nelson
  31. Gary:

    When you come onto an academic website like Podiatry Arena, and you start to promote a product, without making an initial disclaimer that you are profiting from the sale of that product, you are setting yourself up to be called a snake-oil salesman.

    After you first posted to Podiatry Arena, and before I asked if you sell "Oscon" or not, I noted that you have two websites where you sell your product: http://kidsheelpain.com/index.php and http://www.osgood-schlatter.com/index.html On these websites, you have patient testimonials, and make quite a few unreferenced claims about the wonderful nature of your product, all prerequisites to be considered to be a true snake oil salesman.

    You see, Gary, that you are just one in a number of individuals who have come onto this academic website in the last year and told us about how wonderful your product is, but have no research to back up your claims. You may want to do a search on our discussions with Ed Glaser, Brian Rothbart, and Dennis Kiper, all who are podiatrists who sell a product and make quite a few outlandish claims about the therapeutic effectiveness of their products on their websites and in their postings here on Podiatry Arena.

    Therefore, Gary, unless you have some research studies that compare your product to a placebo and to any of the other topical antiinflammatory or topical pain-relief products, then I will have to consider your product to be no more effective than any other topical product at reducing the pain from certain musculoskeletal pathologies.

    Who knows? Maybe Oscon is the next breakthrough in medicine, as you proudly claim on your two websites? However, if you want to impress those of us who have been around a long time, are well-versed in the placebo effect and in scientific research methods, and aren't gullible enough to believe what every snake-oil salesman tells us about their "new product", please provide us with some unbiased research that shows us that your product is truly as special as you claim it is. Otherwise, you are just digging yourself a deeper and deeper hole the more you argue with us.

    Just some friendly advice. Have a nice week.:drinks
  32. Gary Nelson

    Gary Nelson Member


    Who do you recommend to do such a study?
    Did you see my last post with scientific references?
    This is not a new product, it has been around for years. Is there anything that prevents YOU from trying it yourself to see how/if it works?
    I do run across people with the following mantra, such as one of your other posters. I guess I should not let it bother me:

    jb: "I'm not a fan of facts. You see, the facts can change, but my opinion will never change, no matter what are the facts."

    Last edited: Jun 9, 2008
  33. Craig Payne

    Craig Payne Moderator

    None of those case reports or lay writing about that you provided consititute evidence. Nothing you have provided shows that there is any edema or inflammation in Severs.
    I have been treating and teaching about it for 20+ years. You are going to have to do better than that!
    How does this answer the question? It just a case reprot!!!! ANd even then there is nothing in this that shows the fibres of the achilles tendon are involved.
    What rubbish, they are not...and you going to need to provide a more authoriative source if you want to convince us otherwise - a family practice notebook is NOT a very authoriative source. If you claim to know so much about both conditions then you would know the differences (Hint: it has a lot to do with the depth of the insertion of the tendon fibres in relationship to the metaphysis.)
    None of the texts or references that would be considered authoriative recommended it. I wonder why? Why are you putting so much faith in a family practice source? You need to be more critical of your accpetance of things on blind faith.
    I love it ... the very same applie top you.

    Perhaps you could answer that how come in my 20 yrs of treating severs that a soft heel raise (sometimes an orthotic); a bit of achilles stretching; a temporary reduction in activity levels is pretty much what is generally needed to fix them. They get better without anti-inflammatories.

    Please provide us with some good evidence and I will change my mind tomorrow.
  34. Gary Nelson

    Gary Nelson Member


    I am sorry that you offer so little in the way of help. If you had not maligned a product that you know NOTHING about (admit it) I never would have become involved.

    Why not try this: Why don't you PROVE that I am wrong. If you can, I'll concede to you.

    For those of you who maintain an open mind, I would be glad to send you a free sample of Oscon for your own use and evaluation. Then you can tell Craig what it did for you. Just go to my profile and contact me. Since it works rapidly well over 90% of the time, one or two bottles should be enough to convince you.

    One final endorsement:
    Many thanks for your two emails dealing so fully with my question regarding long term safety.
    The students selected by audition for Ballet training all have the criteria described in your first note regarding characteristics of individuals susceptible to apophysitis. You will appreciate that for us this is a problem of the majority rather than the minority.
    Having worked for twenty-five years as both a staff and guest teacher in major schools in Britain, France and Japan and relied in that time on the traditional treatments, rest, physiotherapy and ice, the rate of attrition was still appallingly high. Indeed some students never recovered satisfactorily.
    Although previously believing that Osgood-Schlatter and Severs were the possible culprits there seemed no reason, from the obtained advice, not to accept that while it was possible to alleviate the symptoms they were not fully treatable.
    I obtained parental permission for an experiment in the school after satisfying myself that the formula was safe. I must confess that my using Oscon was an act of desperation with little or no expectation as to its efficacy.
    After a month of use we are seeing a complete return to training with a marked improvement in performance standards as the pain apprehension is removed.
    For you, who have worked with thousands of athletes under these circumstances for many years this will come as no surprise, whereas I, being new to this, am beginning to see the hope of an unexpected light at the end of a dark tunnel and for that I am very grateful.
    My congratulations for your research and the apparent solving of an intractable problem inherent in Ballet Schools for years.
    Kindest regards,
    David Picken.
    Director of Academy.
    RBS Dip(PDTC)
    Diplom D`Etat(reconnue)

    I'm not going to :bang: any more with anyone else here, it is :deadhorse: .

    I will be glad to answer any civil questions. I will debate with intransigents again when :pigs:.

    Gary Nelson
    Last edited: Jun 10, 2008
  35. jb

    jb Active Member


    There is no statistically significant relationship between political satire and evidence-based research.

  36. DaVinci

    DaVinci Well-Known Member

    I have never seen anyone with Severs have any swelling/oedema. Most of the Osgood's I have seen do have swelling/oedmea.
  37. Gary:

    We don't need or want any more of your testimonials for the product you are selling on the internet. What we want is some good research that states your product is better than other treatments that are more commonly accepted in the podiatry and orthopedic professions in order to show to us that it works better than a placebo. So far, you have given us nothing other than testimonials and some references that are not very impressive.

    As far as your statement, "My mind is made up, don't confuse me with the facts." Here are the facts, as I see it.

    1. You come onto an academic website and glorify the therapeutic properties of a product you are profiting from.

    2. You have no good research to back up your claims. You only have testimonials from people we have never heard of before and we don't know even exist, that may have had similar results after 6 weeks by rubbing Vaseline on their heels or knees.

    3. You are asking us to try a product in treating conditions that we treat quite readily and effectively with other commonly accepted clinical means.

    Therefore, Gary, I could also say that you have your mind made up, and don't want to be confused by the facts since those facts may lead to shrinkage of your bank account.

    By the way, if you had been more respectful of Craig Payne, and offered to send him your product and pay for independent testing of your product against other similar products and placebo, then he or one of his research colleagues may have gladly considered doing the research for you. I wouldn't "step on too many more toes" if you are truly interested in finding someone who is willing to do some independent research of your product. Since you are so sure of your product being the next best thing in medicine, this small investment in research should may make you a millionaire someday by selling Oscon. .:rolleyes:
    Last edited: Jun 10, 2008
  38. Secret Squirrel

    Secret Squirrel Active Member

    Mechanical problems need mechanical solutions (I read that somewhere else on this site). Severs Disease is a mechanical problem.
  39. Gary Nelson

    Gary Nelson Member

    Is there inflammation present in Severs Disease (aka Calcaneal Apophysitis) ?

    See: http://www.epodiatry.com/heel-pain-children.htm

    What does the medical term Calcaneal Apophysitis mean?

    Calcaneal; See http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=calcaneal

    Apophysitis; See http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=apophysitis

    Apophysis; See http://www2.merriam-webster.com/cgi-bin/mwmednlm?book=Medical&va=apophysis

    By definition there is inflammation associated with Severs Disease.
  40. drsarbes

    drsarbes Well-Known Member

    Interesting reading!
    I see your first post was February 8th.
    How is your patient?

    Like many here, speaking from experience, most of the patients I see with Sever's are either quite athletic, have decreased dorsiflexion at the ankle - or both.

    I don't, however, relate Severs to adult enthesopathy. Sever's is an apophysitis and should be treated as such. Any additional predispositions can be treated at a later date to decrease the chance of recurrence and to prevent other pain of biomechanical etiology.

    Not all kids with Sever's need orthotics. They do all need a heel cushion of some type. Ice and rest and possibly NSAI's are indicated. I also have seen patient's that required referral to P.T or CAM walker or Cast immobilization. These are usually heavy set youngsters with tight tendoachilles who were not treated quickly enough.


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