DOLOR DE TALÓN EN LOS NIÑOS: ENFERMEDAD DE SEVER – Antonio Juan Ortuño Podólogo Elda

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noviembre 03, 2016 12:19 pm

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DOLOR DE TALÓN EN LOS NIÑOS: ENFERMEDAD DE SEVER

La Enfermedad de Sever o apofisitis calcánea es una causa frecuente de dolor de talón en los niños. Suele aparecer entre los 8 y los 13 años de edad y es más frecuente en el género masculino y en aquellos niños que realizan actividad deportiva, en la mayoría de los casos suele aparecer de manera bilateral.

La apofisitis calcánea es una inflamación aguda del cartílago de crecimiento del talón derivado de la tensión muscular del tendón de Aquíles y de la fascia del pie (sistema aquíleo-calcáneo-plantar) ejercida en la zona durante el periodo de crecimiento. Estas fuerzas repetitivas son las causantes del dolor e inflamación del talón, esto ocurre principalmente en niños muy activos que realizan deportes intensos que implican saltos, carrera,etc.

Factores agravantes:

Sobrepeso
Hiperactividad propia de la edad
Calzado inadecuado para actividades diarias y/o deportivas
Retracción de la musculatura posterior
Alteraciones biomecánicas en el pie (pie cavo, pie plano)

Síntomas:

Dolor intenso durante y después de la actividad física deportiva
Cojera y modificación de la marcha, el niño suele caminar de puntillas evitando el contacto del talón con el suelo y tiende a cerrar el ángulo de la marcha.
Dolor a la palpación en la zona posterior del talón y en la zona de inserción del tendón de Aquiles.

Cuando el dolor persiste y tras el paso de unas semanas no se ha identificado la causa, es conveniente acudir al Podólogo para que realice una exploración exhaustiva del pie y todo el miembro inferior y determine si dicho dolor corresponde a la Enfermedad de Sever o es otro tipo de talalgia. Si se considera oportuno se puede realizar una radiografía para valorar los núcleos de osificación del calcáneo y ver el grado de afectación

Tratamiento:

El tratamiento prioritario en fase aguda es el reposo, combinado con la aplicación de hielo en la zona, siendo necesario en ocasiones el uso de antinflamatorios con el objetivo de disminuir la sintomatología.

La siguiente fase de tratamiento consistiría en evaluar las causas por la que se produce el aumento de tensión en la fascia plantar para buscar la solución definitiva, así como valorar mediante un correcto estudio de la pisada las alteraciones biomecánicas que puede presentar el pie, ya que en la mayor parte de los casos la causa está determinada por una incorrecta forma de pisar.

En el caso de haber alteraciones biomecánicas el tratamiento consistiría en la realización de plantillas totalmente personalizadas para que el niño pueda retomar con normalidad su actividad deportiva en un período corto de tiempo.

Con el tratamiento adecuado la lesión responde muy bien en pocas semanas y no es necesario abandonar la práctica deportiva.

biomecánica, dolor talón niños, estudio de la pisada, plantillas personalizadas, podología infantil

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