Sever?s disease is a common cause of heel pain in children especially in the young and physically active. Severs disease is a painful bone disorder that results from inflammation (swelling) of the
growth plate in the heel. A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the
growth plates expand and unite. It is very important that damage to the growth plate is avoided.
Sever?s Disease is thought to be caused by several reasons. Growth spurts. The muscles and tendons become tight due to rapid bone growth. Overuse. Sever?s Disease can also occur in children who are
athletically active and overwork his or her muscles. Some physicians are beginning to caution parents about checking their children?s shoes to make sure they fit well and do not pinch or put undue
pressure on the child?s feet. Pronation can also bring on Sever?s Disease.
Sever?s is recognized by pain in the back and lower regions of the heel. It usually starts during or immediately following the child's growth spurt, and/or in very active individuals. The child will
usually have pain during or following participation in sport, and will often be seen limping off the field or court. Symptoms of Sever's include painful heel, no swelling or warmth, night pain is
absent, pain is worse with increased activity, pain which is usually relieved by rest. Children often hobble or limp from the sports field.
To diagnose the cause of the child?s heel pain and rule out other more serious conditions, the foot and ankle surgeon obtains a thorough medical history and asks questions about recent activities.
The surgeon will also examine the child?s foot and leg. X-rays are often used to evaluate the condition. Other advanced imaging studies and laboratory tests may also be ordered.
Non Surgical Treatment
Fortunately Severs? disease can be treated and prevented through a number of different techniques that have all proven highly effective. The heel will repair itself even without active treatment
provided that the suffering foot is given a chance to heal. Typically Severs? disease will take 2-8 weeks, although in many cases it can take longer as the continuous growing of the bone can
exacerbate the condition. Podiatrists have an important role in preventing Severs? disease in young athletes, and in treating the condition when it develops so children can get back on their feet as
quickly as possible. Generally treatment involves stretching muscles running down to the heel to relieve tension and pain, these include the hamstrings and calf muscles, and these stretching
exercises will need to be performed at least 2 or 3 times a day. RICE is a classic method of speeding up the recovery of self-healing injuries like Severs? disease. This involves Rest, the
application of Ice to the injury, Compression, and finally Elevation to encourage repaid. These measures can be advised by a trained podiatrist, but it is then up to a child to carry on with regular
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel.
Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and
inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a
cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence
of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle