Sever’s Disease: Episode 54

  • In this episode: Sever’s disease – Is your child experiencing heel pain, especially during sport or after.

  • Chip Review: Lorenz – Crunchips Cheese & Onion – Thank you Steve Kovisto (11:05)

  • Trivia question of the week: Can you name the two state capitals, which contain the entire name of the state in their spelling? (09:25)

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

 

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Brief except from the episode:
Sever’s Disease aka calcaneal apophysitis, juvinille heel pain. It is inflammation of the growth plate of the calcaneus (heel bone).
This is most common in kids going through a growth spurt. Age 12 is the most likely age but it can occur before or after. Boys are more likely then girls to present with this pain.
Almost always pain is produced during physical activity and particularly sports. Pain will linger after and can settle down with a few minutes or hours. Pain always returns with participation in sport again.
Running and jumping sports are the most common. However, it can be seen with any sport depending on activity level.
This issue can be present for several weeks or months and will typical resolve on its own once the bones slow down or stop growing. That is why it is so common during a growth spurt.
Essential what happens is that the pull of the Achilles tendon on the immature skeleton causes the bone to deform. You can sometimes see a more prominent heel bone in adults who as children dealt with Sever’s Disease.
Other episodes you might enjoy:

Achilles Tendonitis: Episode 48

Foot & Ankle Health with Dr. Mohammad Rimawi: Episode 40

Plantar Fasciitis: Episode 11

ACL Reconstruction Options: Episode 46

  • In this episode: We discuss the various options for ACL reconstruction.

  • Chip Review: Lorenz Crunchips – Voodoo Party (Liz Schneider)

  • Trivia question of the week: How many minutes of playtime are there during an average baseball game?

  • Follow us on Instagram: 2pts_n_a_bagofchips and/or Twitter @2PTsNaBagOChips to see photos, video and get additional episode specific information throughout the week.

  • Thanks for listening!!

 

What options do you have when you tear your ACL? Lots of them actually. Saying ACL reconstruction is more specific then repair. The tissue is gone, it has exploded even, and so you are not able to repair that in most cases.
There are two main types of graft tissue, allograft that is from something else. Usually we call this cadaver. There is also an autograft, which is from you. So another area of the body is being repurposed. Usually, patella tendon or hamstring tendon.
Djimmer is actually an expert on this. He has had a patella tendon graft on his right knee and a hamstring graft on the left knee. So a lot of first hand experaince. In addition Djimmer has had a child who has undergone ACL reconstruction. He had a hamstring graft. So you can also speak to the parental aspect of recovery.
Christiaan is also a member of this club. He is ACL deficient. So he has partial torn his ACL and chosen to not have it reconstructed.
Graft type wise. Allo is from a cadaver and traditionally you will see patella but you can see a variety and sometime you won’t know exactly where your graft is coming from.
Outside of graft type one of the most important aspects of a successful reconstruction is getting the angle right. The impact of the surgeon is much more important in recovery and function then the tissue used for the reconstruction. This is because the location of the new “ligament” has much more impact on the function of the knee then what the tissue is made of.
The selection of tissue during an autograft is important because it will immediately impact your recovery. Selecting tissue from your patella or hamstring will cause a second location that also needs to recovery. The benefit of the autograft is that the tissue is fresher, there is almost no chance of rejection and the long-term laxity is typically much lower.
In our opinion the most important aspect to keep in mind when choosing what to do for your ACL reconstruction is to pick the surgeon you feel will do the best job. Within that selection it is typically best to have the surgeon perform the procedure and graft tissue they use most often and would more then likely do best. This will give you the best chance for quicker recovery and long term function and effectiveness.

Other Episodes you might be interested in:

ACL Recovery: Episode 13

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