Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in one or both feet of children during the period when their feet are growing. Sever's disease
occurs most commonly in boys and girls between the ages of 8 and 14 years of age. Sever's disease occurs when the part of the child's heel known as the growth plate, or the calcaneal epiphysis, an
area attached to the Achilles tendon, suffers an injury or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of
the heel and the inability to put any weight on the heel, forcing the child to bear weight on their toes while walking. A toe gait develops in which the child must change the way they walk to avoid
placing weight on the painful heel, a position that can lead to other developmental problems.
There are many contributing factors that cause strain across the growth plate, making your child prone to developing Sever?s disease. These include repeated minor trauma to the growth plate from
running or jumping sports, tight calf or hamstring muscles, rapid growth spurts can lead to the leg muscles becoming tight, increasing tension on the growth plate, tight Achilles tendon, the Achilles
tendon attaches to the back of the heel adjacent to the growth plate, poor foot posture, may increase the strain on the growth plate, footwear with a very low heel pitch (eg soccer boots),
unsupportive or unstable footwear with poor shock absorption at the heel, running or playing sport on hard surfaces.
Activity-related pain that occurs on the back of the heel, where the Achilles tendon attaches on to the heel bone. Tenderness, pain & swelling on the heel bone. Difficulty walking or walking with
a limp or on tiptoes.
In Sever's disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or
she runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that
your child's heel tendons have become tight.
Non Surgical Treatment
The following are different treatment options. Rest and modify activity. Limit running and high-impact activity to rest the heel and lessen the pain. Choose one running or jumping sport to play at a
time. Substitute low-impact cross-training activities to maintain cardiovascular fitness. This can include biking, swimming, using a stair-climber or elliptical machine, rowing, or inline skating.
Reduce inflammation. Ice for at least 20 minutes after activity or when pain increases. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also help. Stretch the calf. Increase calf flexibility by
doing calf stretches for 30 to 45 seconds several times per day. Protect the heel. The shoe may need to be modified to provide the proper heel lift or arch support. Select a shoe with good arch
support and heel lift if possible. Try heel lifts or heel cups in sports shoes, especially cleats. Try arch support in cleats if flat feet contribute to the problem.
The old adage, "An once of prevention is worth a pound of cure," is most appropriate when trying to prevent the effects of Sever's Disease. If this condition is not prevented, or treated in its
earliest stages, it may cause the child to stop certain sports activities until the growth plate has fused and matured (this usually occurs around the age of 16 years old). Long Term Treatment and
Prevention must be directed towards protecting the growth plate at the back of the heel during a child's growing years. Being aware of the following best does this. If the child is very active in
sports that require repetitive and exertive activities, then the parents must be vigilant when it comes to the child's gait, watching to see if he or she is limping, walking on their toes, or
complaining of heel pain when weight-bearing. These may be "early warning signs" of Sever's Disease. Along with these signs, if your child has any of the Predisposing Hereditary Factors listed above,
the chances of Sever's Disease occurring increased.