Sever's disease, also called calcaneal apophysitis, 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, which is how bones grow.
Overuse and stress on the heel bone through participation in sports is a major cause of calcaneal apophysitis. The heel?s growth plate is sensitive to repeated running and pounding on hard surfaces,
resulting in muscle strain and inflamed tissue. For this reason, children and adolescents involved in soccer, track, or basketball are especially vulnerable. Other potential causes of calcaneal
apophysitis include obesity, a tight Achilles tendon, and biomechanical problems such as flatfoot or a high-arched foot.
Pain in the lower calf and heel area which may be worse when applying pressure either side. Pain worse on activity especially those involving running or jumping. In severe cases this may cause the
child to limp when walking. One or both heels affected.
Your podiatrist will take a comprehensive medical history and perform a physical examination including a gait analysis. The assessment will include foot posture assessment, joint flexibility (or
range of motion), biomechanical assessment of the foot, ankle and leg, foot and leg muscle strength testing, footwear assessment, school shoes and athletic footwear, gait analysis, to look for
abnormalities in the way the feet move during gait, Pain provocation tests eg calcaneal squeeze test. X-rays are not usually required to diagnose Sever?s disease.
Non Surgical Treatment
If the problem is bad enough, it is important to totally rest the symptomatic foot. Take a break from sport activity until the pain has significant improvement. Severe cases will need to be treated
with a cast boot. Anti-inflammatory treatments include Icing, Over-the-counter anti-inflammatory medicine as recommended by your pediatrician or podiatrist. Shock absorption and support. Don't go
barefoot at home, wear some type of good sandal or shoe. A significant and/or chronic case should be treated with prescription orthotics. This addresses mechanical problems that cause this problem,
Using an over-the-counter heel cushion inside of the shoe, Athletic foot taping, Stretching. Runners stretch to stretch out the calf muscle. A night splint will also help. Severe or chronic cases
respond best to prescription orthotics with specific modifications for this problem. May require a night splint. Daytime braces that may also help.
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.