Sever’s disease (also known as calcaneal apophysitis) is a type of bone injury that occurs when the growth plate in the lower back of the heel (where the Achilles tendon attaches) becomes inflamed, causing pain. A growth plate is an area of growing tissue near the end of a child’s bones. Growth plates expand as bones develop.
Sever’s disease is one of the most common causes of heel pain in growing children, especially those who are active or play sports regularly.
What are the symptoms?
Pain and tenderness in one or both heels is a sign of Sever’s disease. Other symptoms may also include:
- Pain or swelling in the heel, usually in the back
- Tenderness in the heel that worsens after squeezing the area
- Inflammation in the heel that feels worse after running or jumping on hard surfaces and feels better upon resting
- Difficulty walking
- Walking or running on tiptoe or with a limp
What causes Sever’s disease?
Sever’s disease usually occurs during a growth spurt, when heel bone and the other muscles and tendons in your child’s leg are growing quickly. Sometimes, the heel bone grows faster than the rest of the leg’s muscles, causing them to overstretch and tighten in order to keep up. This can put pressure on the growth plate.
Sever’s disease is particularly common among children who play sports on a hard surface. It can also result from standing for long periods of time.
Diagnosis
To confirm a diagnosis of Sever’s disease, a podiatric foot and ankle specialist will examine the heels and ask about the child’s level of activity and participation in sports. The foot specialist may also test to see if tiptoeing or squeezing the back part of the heel causes more pain. Other tests may also be performed to rule out other problems such as fracture.
Treatment
Sever’s disease does not cause any long-term foot problems. The pain is temporary and typically goes away after a few months. Your podiatrist may recommend rest to relieve the pain. Because symptoms tend to worsen with activity, rest will allow the inflamed heels to become less swollen.
Other recommended treatment options for heel pain may also include:
- Icing. Applying an ice pack helps reduce swelling.
- Stretching exercises. Performing exercises helps stretch and strengthen the muscles and tendons in the heel and foot.
- Supportive footwear. Wearing supportive shoes or using cushioning can help reduce pressure in the heel bone.
To get recommended measures for a quick recovery, consult a podiatrist.
Prevention
Sever’s disease can be prevented in growing bodies by resting between sports games or periods of physical activity; it is important to avoid overdoing a sport.
The risk of injury will decrease at age 15, when puberty is nearly complete and the heel bone is done growing.