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.
Severs disease is often associated with a rapid growth spurt. As the bones get longer, the muscles and tendons become tighter as they cannot keep up with the bone growth. The point at which the
achilles tendon attaches to the heel becomes inflamed and the bone starts to crumble (a lot like osgood schlatters disease of the knee). Tight calf muscles may contribute as the range of motion at
the ankle is reduced resulting in more strain on the achilles tendon. Sever's disease is the second most common injury of this type which is known as an apophysitis.
The symptoms include pain, tenderness, swelling or redness in the heel, and they might have difficulty walking or putting pressure on the heel. If you notice that your child suddenly starts walking
around on their toes because their heels hurt, that?s a dead giveaway. Kids who play sports might also complain of foot pain after a game or practice. As they grow, the muscles and tendons will catch
up and eventually the pressure will subside along with the pain. But in the meantime, it can become very uncomfortable.
Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as
it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.
Non Surgical Treatment
The treatment of Sever's disease should be individualized. The most important first steps in the treatment of Sever's disease are activity modification (including rest and sometimes crutches) and
good shoes. Further treatment may include icing to decrease pain around the calcaneal apophysis, stretching and strengthening exercises, shoe orthotics or medications to relieve pain. Rarely, a
removable cast is necessary to completely rest the foot.
Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling, in which the foot is pointed away from the body, then
curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever's disease. The curling exercise should be done in sets of 10 or 20 repetitions, and
repeated several times throughout the day.