Static and dynamic plantar pressures in children with and without sever disease: a case-control study.
BACKGROUND
Calcaneal apophysitis (Sever disease) has been reported to be the most common cause of heel pain in athletic children.


OBJECTIVE
The study aim was to compare plantar pressure, plantar surface contact area, distribution of body weight across the lower extremities, and prevalence of gastrocnemius ankle equinus and gastrocnemius-soleus ankle equinus (which can cause decreases in ankle dorsiflexion range of motion) in children with and without Sever disease.


METHODS
This was a case-control study.


METHODS
Participants were 56 male students enrolled in a soccer academy. Twenty-eight participants had Sever disease (Sever disease group), and 28 participants were healthy (control group). Dynamic and static peak plantar pressures, plantar surface contact area, and body weight distribution were assessed with pedobarography. A goniometer was used to assess gastrocnemius and gastrocnemius-soleus ankle dorsiflexion range of motion.


RESULTS
Both maximum and average peak pressures and percentages of body weight supported by each heel were significantly higher in the symptomatic feet of participants in the Sever disease group than in the control group. Twenty-six participants with Sever disease but only 8 participants in the control group exhibited bilateral gastrocnemius ankle equinus.


CONCLUSIONS
A limitation of the study is that measurements were obtained from participants who were symptomatic.


CONCLUSIONS
Higher heel plantar pressures under dynamic and static conditions appear to be associated with Sever disease. It is unclear, however, whether these higher pressures are a predisposing factor contributing to the disease or a result of the condition. Gastrocnemius ankle equinus also may be a predisposing factor for Sever disease. Further research is needed to identify other biomechanical factors associated with the disease to enhance prevention and treatment strategies.
R. Becerro-de-Bengoa-Vallejo, PhD, Escuela Universitaria de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.
Ricardo
R
Becerro-de-Bengoa-Vallejo
M.E. Losa-Iglesias, PhD, Facultad Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida Atenas s/n 28922, Alcorcón, Spain. marta.losa@urjc.es.
Marta E
ME
Losa-Iglesias
D. Rodriguez-Sanz, PhD, Centro Ortopedico y Quirurgico del Pie, Madrid, Spain.
David
D
Rodriguez-Sanz
D000293:Adolescent; D000843:Ankle Joint / Q000503:physiopathology*; D002111:Calcaneus / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010007:Osteochondritis / Q000503:physiopathology*; D011312:Pressure; D016059:Range of Motion, Articular / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology*