Severs disease or calcaneal apophysitis causes heel pain usually in growing children between age nine and fourteen. It occurs as a result of disturbance during the final development of the heel
growth plate. During this time the achilles tendon is pulling strongly on the heel bone and this excessive force can cause inflammation and pain.
With early puberty, the growth plate at the end of the heel develops, transforming cartilage cells into bone cells. This painful heel condition occurs during these growth spurts, when the heel bone
grows more rapidly than the muscles and tendons of the leg. The discrepancy between rates of development causes excess pressure and tension to be placed upon the heel and it becomes less flexible.
This condition affects active children the most. Due to the amount of exercise, more stress is placed upon the tendons which in turn causes more damage to the growth plate. The bone plates fully
mature and harden by the time a child reaches the age of 15.
The typical patient is a child between 10 and 13 years of age, complaining of pain in one or both heels with running and walking. The pain is localized to the point of the heel where the
tendo-Achilles inserts into the calcaneus, and is tender to deep pressure at that site. Walking on his toes relieves the pain.
Sever?s disease can be diagnosed based on the symptoms your child has. Your child?s doctor will conduct a physical examination by squeezing different parts of your child?s foot to see if they cause
any pain. An X-ray may be used to rule out other problems, such as a broken bone or fracture.
Non Surgical Treatment
If your child have Sever's disease, the following is suggested, cut back on sporting activities, don't stop, just reduce the amount until symptoms improve (if the condition has been present for a
while, a total break from sport may be needed later) avoid going barefoot, a soft cushioning heel raise is really important (this reduces the pull from the calf muscles on the growth plate and
increases the shock absorption, so the growth plate is not knocked around as much). Stretch the calf muscles, provided the stretch does not cause pain in the area of the growth plate). The use of an
ice pack after activity for 20mins is often useful for calcaneal apophysitis - this should be repeated 2 to 3 times a day.