Although the name might sound pretty frightening, Sever's disease is really a common heel injury that occurs in kids. It can be painful, but is only temporary and has no long-term effects. Calcaneal
apophysitis is a painful inflammation of the heel?s growth plate. It typically affects children between the ages of 8 and 14 years old, because the heel bone (calcaneus) is not fully developed until
at least age 14. Until then, new bone is forming at the growth plate (physis), a weak area located at the back of the heel. When there is too much repetitive stress on the growth plate, inflammation
can develop. Calcaneal apophysitis is also called Sever?s disease, although it is not a true ?disease.? It is the most common cause of heel pain in children, and can occur in one or both feet. Heel
pain in children differs from the most common type of heel pain experienced by adults. While heel pain in adults usually subsides after a period of walking, pediatric heel pain generally doesn?t
improve in this manner. In fact, walking typically makes the pain worse.
Sever's disease can result from standing too long, which puts constant pressure on the heel. Poor-fitting shoes can contribute to the condition by not providing enough support or padding for the feet
or by rubbing against the back of the heel. Although Sever's disease can occur in any child, these conditions increase the chances of it happening. Pronated foot (a foot that rolls in at the ankle
when walking), which causes tightness and twisting of the Achilles tendon, thus increasing its pull on the heel's growth plate, flat or high arch, which affects the angle of the heel within the foot,
causing tightness and shortening of the Achilles tendon, short leg syndrome (one leg is shorter than the other), which causes the foot on the short leg to bend downward to reach the ground, pulling
on the Achilles tendon, overweight or obesity, which puts weight-related pressure on the growth plate
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.
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
Treatment includes modifying activities and resting to reduce pain and inflammation and take pressure off the growth center. Ice can also be very helpful in relieving symptoms, as well as
anti-inflammatory medication. A physical therapy program should be initiated to stretch tight calf muscles and strengthen the ankle muscles to relieve tension on the growth center. Shoes with padded
heel surfaces and good arch support can decrease pain. Cleats may need to be avoided for some time to help reduce symptoms. The doctor may also recommend gel heel cups or supportive shoe
Perform a well rounded dynamic warm up before activity. Perform a good static stretching routine after activity. Increase core strength. Perform exercises that emphasize active lengthening of the
calf muscles. Use proper footwear. Avoid excessive running or jumping on hard surfaces like concrete by using better surfaces such as asphalt, gymnasium floors or grass.