Sever’s disease, also called calcaneal apophysitis, is a painful bone disorder that results from inflammation (swelling) of the growth plate in the heel. A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite, which is how bones grow.
Sever’s disease is a common cause of heel pain in growing kids, especially those who are physically active. It usually occurs during the growth spurt of adolescence, the approximately 2-year period in early puberty when kids grow most rapidly. This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys. Sever’s disease rarely occurs in older teens because the back of the heel usually finishes growing by the age of 15, when the growth plate hardens and the growing bones fuse together into mature bone.
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
The most obvious sign of Sever’s disease is pain or tenderness in one or both heels, usually at the back. The pain also might extend to the sides and bottom of the heel, ending near the arch of the foot.
A child also may have these related problems:
swelling and redness in the heel
difficulty walking
discomfort or stiffness in the feet upon awaking
discomfort when the heel is squeezed on both sides
an unusual walk, such as walking with a limp or on tiptoes to avoid putting pressure on the heel
Symptoms are usually worse during or after activity and get better with rest.
The immediate goal of treatment is pain relief. Because symptoms generally worsen with activity, the main treatment for Sever’s disease is rest, which helps to relieve pressure on the heel bone, decreasing swelling and reducing pain. Occasionally Orthotics are prescribed if underlying conditions are contributing to the heel pain as mentioned above. The best mode of treatment is determined after a consultation and proper assessment from a Podiatrist.
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