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.
Severs disease is often associated with a rapid growth spurt. As the bones get longer, the muscles and tendons become tighter as they cannot keep up with the bone growth. The point at which the
achilles tendon attaches to the heel becomes inflamed and the bone starts to crumble (a lot like osgood schlatters disease of the knee). Tight calf muscles may contribute as the range of motion at
the ankle is reduced resulting in more strain on the achilles tendon. Sever's disease is the second most common injury of this type which is known as an apophysitis.
Some of the common symptoms of Sever's disease are pain in one or both heels with running and walking. The pain is originates from the point of the heel where the tendo-achilles inserts into the heel
bone. Heel pain that goes away when resting. Swollen heel. Calf muscle stiffness first thing in the morning.
Sever's disease is diagnosed based on a doctor?s physical examination of the lower leg, ankle, and foot. If the diagnosis is in question, the doctor may order X-rays or an MRI to determine if there
are other injuries that may be causing the heel pain.
Non Surgical Treatment
Ice the heel(s) well after exercise (until the area is cold and numb!) Stretch hamstring and calf muscles 2-3 times daily (exercises below) REST when pain becomes persistent or moderate (even if it
means skipping games or practices.) Anti-inflammatory medication such as ibuprofen. If symptoms persist, your child may need to see a physical therapist for additional exercises, and/or an
orthopedist for othotics or temporary casting/crutches if pain is severe. Sever?s disease is self-recovering, meaning that it will go away on its own when the heels are rested or when the bone is
through growing. The condition is not expected to create any long-term disability, and expected to subside in 2-8 weeks. However, pain can recur, for example at the start of a new sports season,
several times if it is not taken care of.
For children with Sever's disease, it is important to habitually perform exercises to stretch the hamstrings, calf muscles, and the tendons on the back of the leg. Stretching should be performed 2-3
times a day. Each stretch should be performed for 20 seconds, and both legs should be stretched, even if the pain is only in one heel. Heel cups or an inner shoe heel lifts are often recommended for
patient suffering from Sever's disease. Wearing running shoes with built in heel cups can also decrease the symptoms because they can help soften the impact on the heel when walking, running, or