BACKGROUND: Pain in the heel and Achilles tendon is a common complaint among children between the age of 7 and 12. The condition was first described by Dr. Sever in Boston in 1912 and has been attributed to apophysitis or inflammation of the bone. The treatment has consisted of relative and absolute immobilization using orthotics, cast-boots or casts. Despite treatment, over 50% of children have ongoing or recurrent problems.

HYPOTHESIS: With careful reconsideration of the pathophysiology of the disease, we believe it is caused by a problem in the tendon and a failure of adaptation to increasing loads imposed by rapid growth. Specifically, we have found there is an exponential increase in load on muscles and tendons as children grow. This relationship was the basis of a new theory on the pathophysiology of Duchenne Muscular Dystrophy, published in the journal Muscle & Nerve in September 2013.

CURRENT RESEARCH FINDINGS: We have found that implementation of a very specific 12-week exercise program can result in total resolution of symptoms in as quickly as 2 weeks. By eliminating the use of ineffective orthotics and cast-boots, children are allowed greater mobility during treatment and enjoy a rapid return to sports and physical activities.

47 children have completed the 12-week program. – almost all are experiencing marked resolution or marked improvement in their symptoms, most in the first 2 weeks of treatment. 3 additional participants are currently enrolled; the study will conclude with these 50 patients.

GOAL: The NMRF Research Team is  preparing a manuscript for submission to The American Journal of Sports Medicine.


BACKGROUND: Under the auspices of Napa Medical Research Foundation, Dr. John Diana, Napa orthopedic surgeon and avid ultra-marathon runner, and Dr. Bodor have been appointed by the organizers of the Western States 100 Mile Race to do research and help further our understanding of orthopedic problems and the effects of running and exercise on the human body.

HYPOTHESIS: During the course of a 100 mile run, the amount of load on the hips and knees are equivalent to what a casual athlete or sedentary person might exert during the course of a year, so this gives us an opportunity to look at changes before and after the race and gain insights into what structural variations might lead to symptoms or a good performance.

Hip Labrum tears are thought to be a risk factor for the development of osteoarthritis. By studying hip labral tears in ultra-marathon runners, we can get more rapid feedback as to what might cause pain and dysfunction in the casual athlete or more sedentary person.

IRB approval for this project has been obtained thanks to Adventist Health/St. Helena Hospital.

Read the March 2018 article, Ultra-Marathoners and The Hip: A Study

Related Studies

OSTEOPOROSIS: Correlation with DXA Scanning in Runners

Overview:  Led by Tracy Hoeg, MD, PhD,  the NMRF team will join Emily Kraus, MD and Michael Fredericson from Stanford University to  study correlating risk for osteoporosis as assessed by a previously validated questionnaire with bone density DXA scans performed on 55 male and female ultra-marathon runners. Together, the survey and scans provide key information to researchers about risk factors for decreased bone mineral density as they work to determine the prevalence of osteopenia and osteoporosis at different body sites.

METABOLOMICS: An Exploratory Analysis

Overview: Conducted in conjunction with the UC Davis Departments of Nephrology and Physical Medicine & Rehabilitation, the purpose of this study is to analyze which metabolites in the human body are associated with superior long distance running performance.

Data gathered from participants in the Western States 100-mile endurance race has been analyzed and the manuscript is currently being prepared for publication.


Overview: Working in conjunction with researchers at UC Davis, this cadaveric study aims to validate the ultrasound-guided injection technique used by Marko Bodor, MD, for the delivery of injectate into specific areas of the anterior cruciate ligament (ACL) in the knee. Designed with the help of Jay Smith, MD of Mayo Clinic’s Physical Medicine & Rehabilitation/Sports Medicine Department, cadavers obtained from UC Davis will be delivered to the Anatomy Lab for injection by Dr. Bodor and followed with subsequent discussion with Dr. Gross.


 Reduce Pain. Increase Mobility & Function. Improve Quality of Life.

All the research conducted through the Napa Medical Research Foundation, a 501(c)(3) nonprofit organization, is fully funded through generous donations received from individuals and family foundations.