What is sever's disease? sever's disease is a common cause of heel pain in active children. Sever's disease, also called calcaneal apophysitis, occurs when the growth plate of the heel is injured by
excessive forces during early adolescence.
The exact cause of Severs disease is not completely understood. It is thought to be associated with an overuse type injury, in which repetitive stress from the Achilles tendon causes a portion of the
growth plate to pull away from the heel. In medical terms, this is described as cyclic, micro-avulsion type fractures to the calcaneal apophyses.
Some of the most common signs and symptoms associated with Sever?s disease include. Heel pain or tenderness in one or both heels, usually at the back of the heel. Pain or discomfort upon waking, or
when the heel is squeezed. Heel pain that is worse during or following activity. Limping. Heel swelling or redness. Tight calf muscles. Decreased ankle range of motion.
X-rays are normal in Sever's disease, but your doctor will probably get X-rays to rule out other problems. Treatment consists of non-steroidal anti-inflammatory medications and use of a heel lift to
relieve tension on the calcaneal apophysis. In more severe cases, phycical therapy consisting of modalities to relieve the pain, and stretching exercises may be helpful. In extreme cases, castings
have been used.
Non Surgical Treatment
Orthotic insoles are a common form of treatment for Sever?s disease as they provide support and cushioning to the area which reduces the pressure and stress to the area. Our podiatrist can also show
your child stretches and exercises to help them manage their pain as well offering them advice on their exercise and activity.
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel.
Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and
inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a
cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence
of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle