What Is Severs Disease?

Overview

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.

Causes

A big tendon called the Achilles tendon joins the calf muscle at the back of the leg to the heel. Sever?s disease is thought to occur because of a mismatch in growth of the calf bones to the calf muscle and Achilles tendon. If the bones grow faster than the muscles, the Achilles tendon that attaches the muscle to the heel gets tight. At the same time, until the cartilage of the calcaneum is ossified (turned into bone), it is a potential weak spot. The tight calf muscle and Achilles tendon cause a traction injury on this weak spot, resulting in inflammation and pain. Sever?s disease most commonly affects boys aged ten to 12 years and girls aged nine to 11 years, when growth spurts are beginning. Sever?s disease heals itself with time, so it is known as ?self-limiting?. There is no evidence to suggest that Sever?s disease causes any long-term problems or complications.

Symptoms

Symptoms of Sever?s disease, mostly pain at the back of heel, usually occur during and after sporting activity, and usually disappear with rest. In some cases, children may find it difficult to place pressure on their heels, and begin walking on their toes to gain relief. For some children, the heel pain will persist until the next morning, causing some stiffness or hobbling on first arising. Some children may experience mild swelling at the back of the heel.

Diagnosis

A doctor or other health professional such as a physiotherapist can diagnose Sever?s disease by asking the young person to describe their symptoms and by conducting a physical examination. In some instances, an x-ray may be necessary to rule out other causes of heel pain, such as heel fractures. Sever?s disease does not show on an x-ray because the damage is in the cartilage.

Non Surgical Treatment

Depending on the underlying cause, treatment can include. Arch supports (foot orthoses) to correctly support the feet. Proper taping of the foot and heel. Rest from activities. Icing at the end of the day. A night splint worn at night. Flexibility exercises and strengthening. Ultrasound therapy. Anti-inflammatory drugs.

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