What type of orthotic do you prescribe for Sever’s disease (calcaneal apophysitis)?
The main complaint of children with calcaneal apophysitis is usually pain upon ambulation because the tendo Achilles is too tight and there is compression at the closing growth plate, according to Dr. Jay. If symptoms are mild to moderate, he usually prescribes a temporary heel rise to the insert. He prefers not to go any higher than 1/4 to 1/2 inch and usually recommends placing the rise into a high-heeled sneaker. Dr. Volpe prefers using a device with a deep heel seat to cup and hold the plantar fat pad under the calcaneus. While the material should be relatively non-compressible to limit abnormal motions and contain the fat pad, Dr. Volpe says it should not be too rigid as this may increase irritation to the apophysis. He notes other options include incorporating a heel cushion on the dorsal surface of the shell and adding heel lifts for equinus influences when appropriate. When it comes to Sever’s disease, Dr. Valmassy will make specific modifications such as fully addressing the e
