Severs disease, also known as calcaneal apophysitis, is a condition in which the growth plate along the heel becomes inflamed. It most commonly occurs in active, early-teen children. Most patients
with Severs disease complain of heel pain. In general the pain is exacerbated with increased activities, such as running, jumping, or climbing stairs. The pain often improves with a period of
Children are at greatest risk of developing Sever's disease when they have reached the early part of a growth spurt in early puberty. For girls, this is typically around ages 8 to 10. For boys, it
happens somewhere between the ages of 10 to 12. By the age of 15, the back of the heel has typically stopped growing in most children, and Sever's disease becomes rare. Any running or jumping
activities can increase the odds that a child will develop Sever's disease. Soccer and gymnastics are two common sports that tend to put kids at risk.
Sever's Disease is most commonly seen in physically active girls and boys from ages 10 to 15 years old. These are the years when the growth plate is still ""open,"" and has not fused into mature
bone. Also, these are the years when the growth plate is most vulnerable to overuse injuries, which are usually caused by sports activities. The most common symptoms of this disease include. Heel
pain in one or both heels. Usually seen in physically active children, especially at the beginning of a new sports season. The pain is usually experienced at the back of the heel, and includes the
following areas. The back of the heel (that area which rubs against the back of the shoe). The sides of the heel. Actually, this is one of the diagnostic tests for Sever's Disease, squeezing the rear
portion of the heel from both sides at the same time will produce pain. It is known as the Squeeze Test.
Sever's disease is diagnosed based on a doctor?s physical examination of the lower leg, ankle, and foot. If the diagnosis is in question, the doctor may order X-rays or an MRI to determine if there
are other injuries that may be causing the heel pain.
Non Surgical Treatment
First, your child should cut down or stop any activity that causes heel pain. Apply ice to the injured heel for 20 minutes 3 times a day. If your child has a high arch, flat feet or bowed legs, your
doctor may recommend orthotics, arch supports or heel cups. Your child should never go barefoot. If your child has severe heel pain, medicines such as acetaminophen (one brand name: Tylenol) or
ibuprofen (some brand names. Advil, Motrin, Nuprin) may help.
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel.
Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and
inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a
cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence
of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle