Overview
Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in one or both feet of children during the period when their feet are growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14 years of age. Sever's disease occurs when the part of the child's heel known as the growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, suffers an injury or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel, forcing the child to bear weight on their toes while walking. A toe gait develops in which the child must change the way they walk to avoid placing weight on the painful heel, a position that can lead to other developmental problems.
Causes
During the growth spurt of early puberty, the bones often grow faster than the leg muscles and tendons. This can cause the muscles to become very tight and overstretched, the heel becomes less flexible and this build-up of pressure can result in redness, swelling, tenderness and pain at the heel.
Symptoms
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.
Diagnosis
A doctor can usually tell that a child has Sever's disease based on the symptoms reported. To confirm the diagnosis, the doctor will probably examine the heels and ask about the child's activity level and participation in sports. The doctor might also use the squeeze test, squeezing the back part of the heel from both sides at the same time to see if doing so causes pain. The doctor might also ask the child to stand on tiptoes to see if that position causes pain. Although imaging tests such as X-rays generally are not that helpful in diagnosing Sever's disease, some doctors order them to rule out other problems, such as fractures. Sever's disease cannot be seen on an X-ray.
Non Surgical Treatment
Management by a health professional of Sever's disease is often wise. There are a few very rare problems that may be causing the pain, so a correct diagnosis is extremely important. Advice should be given on all of what is mentioned above, appropriate activity levels, the use of ice, always wearing shoes, heel raises and stretching, follow this advice. As a pronated foot is common in children with this problem, a discussion regarding the use of foot orthotics long term may be important. Strapping or tape is sometimes used during activity to limit the ankle joint range of motion. If the symptoms are bad enough and not responding to these measures, medication to help with anti-inflammatory may be needed. In some cases the lower limb may need to be put in a cast for 2-6 weeks to give it a good chance to heal. After the calcaneal apophysitis resolves, prevention with the use of stretching, good supportive shock absorbing shoe and heel raises are important to prevent it happening again.
Prevention
Sever?s disease may be prevented by maintaining good flexibility while your child is growing. The stretching exercises mentioned here can lower your child?s risk for injuries during the growth spurt. Good-quality shoes with firm support and a shock-absorbent sole will help. Your child should avoid excessive running on hard surfaces. If your child has already recovered from Sever?s disease, stretching and putting ice on the heel after activity will help keep your child from getting this condition again.
Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in one or both feet of children during the period when their feet are growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14 years of age. Sever's disease occurs when the part of the child's heel known as the growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, suffers an injury or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel, forcing the child to bear weight on their toes while walking. A toe gait develops in which the child must change the way they walk to avoid placing weight on the painful heel, a position that can lead to other developmental problems.
Causes
During the growth spurt of early puberty, the bones often grow faster than the leg muscles and tendons. This can cause the muscles to become very tight and overstretched, the heel becomes less flexible and this build-up of pressure can result in redness, swelling, tenderness and pain at the heel.
Symptoms
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.
Diagnosis
A doctor can usually tell that a child has Sever's disease based on the symptoms reported. To confirm the diagnosis, the doctor will probably examine the heels and ask about the child's activity level and participation in sports. The doctor might also use the squeeze test, squeezing the back part of the heel from both sides at the same time to see if doing so causes pain. The doctor might also ask the child to stand on tiptoes to see if that position causes pain. Although imaging tests such as X-rays generally are not that helpful in diagnosing Sever's disease, some doctors order them to rule out other problems, such as fractures. Sever's disease cannot be seen on an X-ray.
Non Surgical Treatment
Management by a health professional of Sever's disease is often wise. There are a few very rare problems that may be causing the pain, so a correct diagnosis is extremely important. Advice should be given on all of what is mentioned above, appropriate activity levels, the use of ice, always wearing shoes, heel raises and stretching, follow this advice. As a pronated foot is common in children with this problem, a discussion regarding the use of foot orthotics long term may be important. Strapping or tape is sometimes used during activity to limit the ankle joint range of motion. If the symptoms are bad enough and not responding to these measures, medication to help with anti-inflammatory may be needed. In some cases the lower limb may need to be put in a cast for 2-6 weeks to give it a good chance to heal. After the calcaneal apophysitis resolves, prevention with the use of stretching, good supportive shock absorbing shoe and heel raises are important to prevent it happening again.
Prevention
Sever?s disease may be prevented by maintaining good flexibility while your child is growing. The stretching exercises mentioned here can lower your child?s risk for injuries during the growth spurt. Good-quality shoes with firm support and a shock-absorbent sole will help. Your child should avoid excessive running on hard surfaces. If your child has already recovered from Sever?s disease, stretching and putting ice on the heel after activity will help keep your child from getting this condition again.