Also known as calcaneal apophysitis, Severs? disease is a condition that primarily affects children between the ages of 7 and 15. The condition is typified by pain in the heel which can affect
movement, and as a foot condition, comes under the care of podiatrists. Podiatrists are specially trained professionals who specialise in any and all ailments of the foot and ankle. Podiatrists
dealing with Severs? disease are typically podopaediatricians, individuals who have received training in the delivery of childhood care.
The cause of the pain in Severs disease is thought to be the tractional forces applied to the growth plate of the heel bone by the Achilles tendon at the rear of the heel bone and the plantar fascia
just beneath the heel bone. This pulling force by the Achilles tendon on the growth plate is often aggravated by tight calf muscles and excessively pronated feet (i.e. feet that ?roll in? too
The pain is at the heel or around the Achilles tendon. This is felt commonly during exercise, particularly activities involving running or jumping. The back of the heel may also be tender to touch
and there may be localised swelling. There may be stiffness in the calf muscles first thing in the morning and you may notice limping or a tendency to tiptoe.
You may have pain when your doctor squeezes your heel bone. You may have pain when asked to stand or walk on your toes or on your heels. You may have pain in your heel when your doctor stretches your
calf muscles. Your doctor may order x-rays of the injured foot to show an active growth plate.
Non Surgical Treatment
The following are different treatment options. Rest and modify activity. Limit running and high-impact activity to rest the heel and lessen the pain. Choose one running or jumping sport to play at a
time. Substitute low-impact cross-training activities to maintain cardiovascular fitness. This can include biking, swimming, using a stair-climber or elliptical machine, rowing, or inline skating.
Reduce inflammation. Ice for at least 20 minutes after activity or when pain increases. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also help. Stretch the calf. Increase calf flexibility by
doing calf stretches for 30 to 45 seconds several times per day. Protect the heel. The shoe may need to be modified to provide the proper heel lift or arch support. Select a shoe with good arch
support and heel lift if possible. Try heel lifts or heel cups in sports shoes, especially cleats. Try arch support in cleats if flat feet contribute to the problem.
Sever's disease may be prevented by maintaining good joint and muscle flexibility in the years leading up to, and during, their growth spurts (eg girls 8 to 10, boys 10 to 12). Foot arch problems
such as flat feet should be addressed after the age of five if they don't appear to be self-correcting. If you are concerned, please ask your health practitioner. The most important factor is the
amount of weight-bearing exercise your child is currently performing. Finally, LISTEN To Your Child! If your child is suffering heel pain between the ages of 8 to 12, suspect Sever's disease until
proven otherwise. Seek the professional opinion of your foot practitioner regarding its diagnosis and subsequent management.