Sever?s disease is caused by the growth plate in the heel becoming inflamed, and it is the most common cause of heel pain in adolescents. This condition is especially prevalent in children who play
sports. Treatment includes ice, rest, and pain relievers to manage pain and discomfort. Any underlying foot conditions may also need to be assessed and managed. Sever?s disease does not cause any
permanent damage, and will resolve when the growth of the heel is complete. Sever?s disease (also called calcaneal apophysitis) is a condition that occurs in the growth plate of the heel bone (the
calcaneus) in children and adolescents. When the muscles and tendons in the leg and heel exert too much pressure on this growth plate, swelling and pain can result.
When a baby is born, most of the bones are still cartilage with only some starting to develop into bone. When the heel (calcaneus) starts to develop bone, there is generally one large area of
development that starts in the center of the cartilage heel. This area of bone spreads to 'fill up' the cartilage. Another area of bone development (ossification) occurs at the back of the heel bone.
These two areas of developing bone will have an area of cartilage between them, this is how the bone grows in size. At around age 16, when growth is nearly complete, these two bony areas fuse
together. Sever's disease or calcaneal apophysitis is usually considered to be due to damage or a disturbance in this area of growth.
Signs and symptoms of Sever?s disease include heel pain can be in one or both heels, and it can come and go over time. Many children walk or run with a limp, they may walk on their toes to avoid
pressure on their heels. Heel pain may increase with running or jumping, wearing stiff, hard shoes (ex. soccer cleats, flip-flops) or walking barefoot. The pain may begin after increasing physical
activity, such as trying a new sport or starting a new sports season.
A Podiatrist can easily evaluate your child?s feet, to identify if a problem exists. Through testing the muscular flexibility. If there is a problem, a treatment plan can be create to address the
issue. At the initial treatment to control movement or to support the area we may use temporary padding and strapping and depending on how successful the treatment is, a long-term treatment plan will
be arranged. This long-term treatment plan may or may not involve heel raises, foot supports, muscle strengthening and or stretching.
Non Surgical Treatment
The aim of treatment is to reduce the pain and inflammation when gently stretch the muscles. There is likely to be no magic instant cure and the young athlete may have to be patient while they grow.
Rest and apply ice or cold therapy to the heel. Do not apply ice directly to the skin but wrap in a wet tea towel to avoid ice burns. Rest from activities which cause pain. If running and playing
football makes it worse then reduce or stop this activity and try cycling or swimming to maintain fitness. A temporary measure is to insert a heel pad or heel raise into the shoes. This has the
effect of raising the heel and shortening the calf muscles and so taking the strain off the back of the heel. However long term use of a heal raise may shorten the calf muscles when they need
stretching. Stretch the calf muscles regularly. Stretching should be done pain free and very gently with this injury. See a sports injury professional who can advise on treatment and rehabilitation.