Severs Disease

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Severs Disease

Sever’s disease or calcaneal apophysitis is the most common cause of heel pain in the growing child and is due to repetitive micro-trauma of the growth plate within the calcaneus (heel bone). Though horribly painful it is not a disease, but an overuse condition. Sever’s is most common between the ages 8 to 14 and is more common in boys than girls.

Symptoms

  • Pain or tenderness around the edges of the heel
  • Pain with rising from rest
  • Limp
  • Pain during and after sport

Causes

During development, our skeleton has plenty of open growth plates (soft spongy bone). These growth plates eventually become hard bone as we near skeletal development. The irritation of these growth plates can cause some serious pain.

Boys and girls whom develop Sever’s will likely have:

  • Tight calf muscles and achilles tendon
  • Over-pronated feet/collapsing arches
  • Rapid increase in height and weight
  • Play explosive sports such as soccer, hockey, football etc.
  • Hard playing surfaces, lots of barefoot running
  • Sudden increase in activity (start of sport season)
  • Poor footwear (lack of cushioning and support)

Treatment

  • Reduce physical activity but don’t completely stop
  • Gently calf stretches
  • Heat rubs and anti inflam gel
  • Avoid going barefoot, correct supporting footwear
  • Taping for support and to unload the achilles

If the symptoms are not improving then the underlying biomechanics need to be addressed. This may include:

  • Cushioned heel raises to reduce the strain on the growth plate
  • Orthotics to unload the heel from compressive and tensile force.

Sever’s disease is self-limiting, this means that as the bony growth plate fuses solid the pain goes. The problem is, this may take MONTHS or YEARS to happen and can change our children’s perception of physical activity that can carry into their adulthood.

They are at a point in their lives where they are developing at a rate of knots, physically, mentally and socially. Sore heels will only slow this progress and are quite easy to manage!

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