Sever's disease, or calcaneal apophysitis, is a common cause of heel pain among active children between 10 to 13 years old. This spontaneous heel pain results from injury to the heel bone?s growth
plate which is caused by overuse rather than specific injury or trauma. The condition is common among athletic children, particularly those active in soccer, football, and baseball. Treatment is
available to reduce pain and discomfort associated with Sever's disease, but the condition usually resolves on its own once feet stop growing.
During the growth spurt of early puberty, the heel bone sometimes grows faster than the leg muscles and tendons. This can cause the muscles and tendons to become very tight and overstretched, making
the heel less flexible and putting pressure on the growth plate. The Achilles tendon is the strongest tendon that attaches to the growth plate in the heel. Over time, repeated stress, from physical
activities and sports, on the Achilles tendon damages the growth plate, causing the swelling, tenderness, and pain of Sever's disease.
Sever's disease causes pain and tenderness in the back and bottom of the heel when walking or standing, and the heel is painful when touched. It can occur in one or both feet.
A physical exam of the heel will show tenderness over the back of the heel but not in the Achilles tendon or plantar fascia. There may be tightness in the calf muscle, which contributes to tension on
the heel. The tendons in the heel get stretched more in patients with flat feet. There is greater impact force on the heels of athletes with a high-arched, rigid foot.
Non Surgical Treatment
Treatment of Severs disease usually involves a combination of an accurate analysis of your child?s gait, muscles, tendons, ligaments and joints is a crucial first step. Specific stretching and
strengthening exercises often make up part of the treatment. Anti-inflammatory measures such as ice baths after exercise can be helpful in the short term. Footwear review, assessment and advice is
important. Orthotic devices are often needed to firstly control any abnormal traction or tension on the heel growth plate and, secondly, too unload the ground reaction forces on the heel bone.
Podiatry Care has podiatrists with specific paediatric training enabling them to utilise treatment options to relieve heel pain in children very quickly. If your child is struggling to play sport,
see a Podiatry Care podiatrist near you. In severe cases modification to activity levels may be required. Treatment of Severs disease does NOT require surgery. This foot condition responds very well
to conservative treatment.
In some cases, children will simply outgrow Sever's Disease when they reach a certain age, but this does not mean that symptoms should be ignored. If children express that they are in pain, this
should always be taken seriously by their parents or guardians. Heel pain may be a sign of Sever's Disease and this condition should not be left untreated, due to the damage it can cause to the
growing heel bones. Scheduling a doctor's appointment is always the first step to take in gaining a diagnosis of symptoms and speedy help for the child.