What is Sever’s Disease?
Calcaneal apophysitis, more commonly known as Sever’s Disease, is not a true disease. Sever’s disease is an inflammation of the growth plate in the heel bone, where the Achilles tendon attaches. It is the most common cause of heel pain in children and it can occur in one or both feet. Sever’s disease typically affects children between the ages of 8 and 14 years old, because the heel bone (calcaneus) is not fully developed.
What causes Sever’s Disease?
Overuse and stress on the heel bone through participation in sports are major causes of Sever’s disease. The heel’s growth plate is sensitive to repeated running and pounding on hard surfaces, resulting in inflamed tissue. Another cause of Sever’s disease is tight Achilles tendons and hamstring muscles. Biomechanical problems, such as flat feet or high-arched feet can also predispose children to Sever’s Disease.
Symptoms of Sever’s Disease
Patients with Sever’s disease will typically present with complaints of pain in the back of the heel. The pain is usually worse with running and jumping activities and even more so in sports played in cleats or on hard surfaces. Patients with Sever’s Disease may limp during or after activities. The pain often resolves with rest.
Diagnosing Sever’s Disease
Your doctor will perform a thorough physical exam of the heel and the lower legs in order to diagnose Sever’s disease. Typically, x-rays are ordered to rule out any other bone conditions.
Treating Sever’s Disease
Treatment for Sever’s disease is nonoperative. Initial treatments involve stretching, particularly the heel cords, and NSAIDs (such as ibuprofen). Physical therapy modalities can be helpful. Cushioned shoe inserts or custom orthotic devices may provide padding and support. When pain is more significant or unmanageable, activity modification may be helpful. In severe cases, immobilization may be necessary.
Often, heel pain can return after it has been treated because the heel bone is still growing. Chances of a child developing heel pain can be reduced by encouraging stretching before and after activities. Your child should wear supportive sneakers with heel cushioning that are appropriate for the child’s activity.
If your child has a repeat bout of heel pain, be sure to make an appointment with us at the Pediatric Orthopedic Center. The Pediatric Orthopedic Center is the premier NJ hub for pediatric orthopedics, with four offices throughout northern NJ. Having been the leader in pediatric orthopedics in this area for over 25 years, we are the largest and most award-winning pediatric orthopedic practice in the tri-state area.
