Sever's Disease, also known as calcaneal apophysitis, is a disease of the growth plate of the bone and is characterized by pain in the heel of a child's foot, typically brought on by some form of
injury or trauma. This condition is most common in children ages 10 to 15 and is frequently seen in active soccer, football, or baseball players. Sport shoes with cleats are also known to aggravate
the condition. The disease mimics Achilles tendonitis, an inflammation of the tendon attached to the back of the heel. A tight Achilles tendon contributes to Sever's Disease by pulling excessively on
the growth plate of the heel bone (calcaneus). Treatment includes cutting back on sports activities, calf muscle stretching exercises, heel cushions in the shoes, icing, and/or anti-inflammatory
There are usually two root causes of Sever?s disease that we?ve found that effect young athletes. Arches are not supported causing a dysfunctional run, jump, and landing. The calves (gastrocnemius
and soleus muscles) are overworked, tight, and do not allow proper movement of foot which puts extreme pressure on the Achilles? tendon, in turn irritating the growth plate in the heel.
The most prominent symptom of Sever's disease is heel pain which is usually aggravated by physical activity such as walking, running or jumping. The pain is localized to the posterior and plantar
side of the heel over the calcaneal apophysis. Sometimes, the pain may be so severe that it may cause limping and interfere with physical performance in sports. External appearance of the heel is
almost always normal, and signs of local disease such as edema, erythema (redness) is absent. The main diagnostic tool is pain on medial- lateral compression of the calcaneus in the area of growth
plate, so called squeeze test. Foot radiographs are usually normal. Therefore the diagnosis of Sever's disease is primarily clinical.
This can include physical examination and x-ray evaluation. X-rays may show some increased density or sclerosis of the apophysis (island of bone on the back of the heel). This problem may be on one
side or bilateral.
Non Surgical Treatment
Fortunately Severs? disease can be treated and prevented through a number of different techniques that have all proven highly effective. The heel will repair itself even without active treatment
provided that the suffering foot is given a chance to heal. Typically Severs? disease will take 2-8 weeks, although in many cases it can take longer as the continuous growing of the bone can
exacerbate the condition. Podiatrists have an important role in preventing Severs? disease in young athletes, and in treating the condition when it develops so children can get back on their feet as
quickly as possible. Generally treatment involves stretching muscles running down to the heel to relieve tension and pain, these include the hamstrings and calf muscles, and these stretching
exercises will need to be performed at least 2 or 3 times a day. RICE is a classic method of speeding up the recovery of self-healing injuries like Severs? disease. This involves Rest, the
application of Ice to the injury, Compression, and finally Elevation to encourage repaid. These measures can be advised by a trained podiatrist, but it is then up to a child to carry on with regular
After the painful symptoms of Sever's disease have gone away, it is important to continue stretching the heel, particularly before a vigorous exercise, and wearing good supportive shoes fitted with
children's arch supports. This will prevent heel pain recurrence until the child's heel is fully developed and less prone to injury.