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 thought to be caused by several reasons. Growth spurts. The muscles and tendons become tight due to rapid bone growth. Overuse. Sever?s Disease can also occur in children who are
athletically active and overwork his or her muscles. Some physicians are beginning to caution parents about checking their children?s shoes to make sure they fit well and do not pinch or put undue
pressure on the child?s feet. Pronation can also bring on Sever?s Disease.
If your child has any of the following symptoms, call your pediatrician for an evaluation. Heel pain that begins after starting a new sports season or a new sport. Walking with a limp or on tiptoes.
Pain that increases with running or jumping. Heel tendon that feels tight. Pain when you squeeze the child's heel near the back. Pain in one or both heels.
The doctor may order an x-ray because x-rays can confirm how mature the growth center is and if there are other sources of heel pain, such as a stress fracture or bone cyst. However, x-rays are not
necessary to diagnose Sever?s disease, and it is not possible to make the diagnosis based on the x-ray alone.
Non Surgical Treatment
The physiotherapist will thoroughly assess the affected areas and general mechanics to determine what factors may be contributing, also to rule out any other injuries or stress fractures, etc.
Treatment focusing on the affected area will consist of modified rest, ice, massage, stretches and electrotherapy. A foam heel raise may also be given to help decrease pain. The physiotherapist may
also treat other areas if biomechanical problems are noted. This may include massage, mobilization and exercises to stretch and strengthen certain areas. They may also refer the patient to see a
podiatrist if they believe the foot posture is a factor.
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.