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.
Apart from the age of the young person, other factors that may contribute to developing the disease may include; overuse or too much physical activity. Your child?s heel pain may be caused by repeated stress on the heels (running and jumping activities), pressure on the back of the heel from too much standing or wearing poor-fitting shoes. This includes shoes that do not support or provide enough padding for your child?s feet.
This syndrome can occur unilaterally or bilaterally. The incidence of bilaterally is approximately 60%. Common signs and symptoms include posterior inferior heel pain (over the medial and lateral surface of the bone). Pain is usually absent when the child gets up in the morning. Increased pain with weight bearing, running or jumping (= activity-related pain). The area often feels stiff. The child may limp at the end of physical activity. Tenderness at the insertion of the tendons (= an avascular necrosis of the arthropathy). Limited ankle dorsiflexion range secondary to tightness of the Achilles tendon. Hard surfaces and poor-quality or worn-out athletic shoes contribute to increased symptoms. The pain gradually resolves with rest. Reliability or validity of methods used to obtain the ankle joint dorsiflexion or biomechanical malalignment data are not commented upon, thus reducing the quality of the data. Although pain and limping are mentioned as symptomatic traits, there have been no attempts to quantify the pain or its effect on the individual.
Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.
Non Surgical Treatment
Once diagnosed, there is a list of treatment options available to begin the recovery process. Unfortunately due to the nature of the condition it will often be a reoccurring condition until closure of the growth plates of the heel and elongation of the soft tissue structures. However with appropriate education, correct management of symptoms and prevention strategies, Severs disease can be well managed by the individual and their parents.
It may take several weeks or months for the pain to completely stop. When the pain is completely gone, your child may slowly return to his or her previous level of activity.