Sever's disease is a disorder that commonly occurs in active children between the ages of 9 and 13 years of age. Even though it is misnamed as a disease, it is actually a self-limiting disorder that
occurs around the growth plate in the back of the heel. The Achilles tendon attaches to the upper portion of the heel growth plate. On the bottom of the growth plate is an attachment of a ligament
known as the plantar fascia. With increased activity, there is a pulling or tugging that occurs on this growth plate, and a portion of the growth plate is being pulled away from its attachment to the
heel. X-rays are often taken to verify the position and location of this growth plate.
Sever?s disease is directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves a lot of heel movement. It can be associated with
starting a new sport, or the start of a new season. Children who are going through adolescence are also at risk of getting it because the heel bone grows quicker than the leg. Too much weight bearing
on the heel can also cause it, as can excessive traction since the bones and tendons are still developing. It occurs more commonly in children who over-pronate, and involves both heels in more than
half of patients.
Severs causes swelling, pain and tenderness over the back of the heel. Your child may walk with a limp. Initially the pain may be intermittent occurring only during or after exercise. As the problem
gets worse, pain may be present most of the time. The swelling increases and is painful when touched or knocked. It commonly affects boys who are having a growth spurt during their pre-teen or
teenage years. One or both knees may be affected.
It is not difficult for a doctor to diagnose Sever's disease in a youngster or teenager. A personal history and a physical examination are usually all it takes to determine the cause of heel
Non Surgical Treatment
Orthotic insoles are a common form of treatment for Sever?s disease as they provide support and cushioning to the area which reduces the pressure and stress to the area. Our podiatrist can also show
your child stretches and exercises to help them manage their pain as well offering them advice on their exercise and activity.
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