Sever's disease (calcaneal apophysitis) is an inflammatory condition that affects the heel bone (calcaneus). It happens frequently in young athletes between the ages of 10 and 13, causing pain in one
or both heels when walking. Tenderness and swelling may also be present. Similar to another overuse condition, Osgood-Schlatter disease, Sever's disease has occasionally been termed Osgood-Schlatter
of the heel. In young people, the heel bones are still divided by a layer of cartilage. During the growth years, the bone is growing faster than tendons. This makes it likely that the heel cord will
be applying great tension where it inserts into the heel bone. In addition, the heel cord is attached to an immature portion of the heel bone, the calcaneal apophysis. In young athletes, the
repetitive stress of running and jumping while playing soccer and basketball may cause an inflammation of the growth center of the heel.
Apart from age, other factors that may contribute to developing Sever?s disease include physical activity, any form of exercise that is weight bearing through the legs or stresses the soft tissue can
exacerbate the pain of the disease, External factors, for example, running on hard surfaces or wearing inappropriate shoes during sport Overuse injury, very active children may repeatedly but subtly
injure the bones, muscles and tendons of their feet and ankles. In time, the accumulated injuries cause symptoms.
In Sever?s disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or
she stands on tiptoe. Your child?s heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your provider may also find that your child?s heel tendons have
A physical exam of the heel will show tenderness over the back of the heel but not in the Achilles tendon or plantar fascia. There may be tightness in the calf muscle, which contributes to tension on
the heel. The tendons in the heel get stretched more in patients with flat feet. There is greater impact force on the heels of athletes with a high-arched, rigid foot.
Non Surgical Treatment
See a Podiatrist. Minimise inflammation, by the use of ice, rest and reduction of activity. Minimise pain with the use of anti-inflammatory medications. Shoes have been shown to attenuate shock and
reduce impact on the heel. Effective cushioning in the rear through specifcally placed cushioning units, such as GEL under the heel. A 10mm heel gradient that creates a more efficient foot posture
and therefore reducing strain on the lower limb. Sever's is self limiting and only possible when the growth plate is still present, and does not exist once the growth plates have closed. Podiatrists
have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.
With proper care, your child should feel better within 2 weeks to 2 months. Your child can start playing sports again only when the heel pain is gone. Your doctor will let you know when physical
activity is safe.