Sever's disease (calcaneal apophysitis) is an inflammatory condition that affects the heel bone (calcaneus). It happens frequently in young athletes between the ages of 10 and 13, causing pain in one
or both heels when walking. Tenderness and swelling may also be present. Similar to another overuse condition, Osgood-Schlatter disease, Sever's disease has occasionally been termed Osgood-Schlatter
of the heel. In young people, the heel bones are still divided by a layer of cartilage. During the growth years, the bone is growing faster than tendons. This makes it likely that the heel cord will
be applying great tension where it inserts into the heel bone. In addition, the heel cord is attached to an immature portion of the heel bone, the calcaneal apophysis. In young athletes, the
repetitive stress of running and jumping while playing soccer and basketball may cause an inflammation of the growth center of the heel.
During the growth spurt of early puberty, the heel bone (also called the calcaneus) sometimes grows faster than the leg muscles and tendons. This can cause the muscles and tendons to become very
tight and overstretched, making the heel less flexible and putting pressure on the growth plate. The Achilles tendon (also called the heel cord) is the strongest tendon that attaches to the growth
plate in the heel. Over time, repeated stress (force or pressure) on the already tight Achilles tendon damages the growth plate, causing the swelling, tenderness, and pain of Sever's disease. Such
stress commonly results from physical activities and sports that involve running and jumping, especially those that take place on hard surfaces, such as track, basketball, soccer, and
Often the condition is self limiting; meaning as the growth plate fuses to the rest of the heel bone, the pain will subside. However in some cases the child will have so much discomfort that they
will be unable to walk comfortably if left untreated. Therefore, heel pain in children should always by evaluated by a physician.
You may have pain when your doctor squeezes your heel bone. You may have pain when asked to stand or walk on your toes or on your heels. You may have pain in your heel when your doctor stretches your
calf muscles. Your doctor may order x-rays of the injured foot to show an active growth plate.
Non Surgical Treatment
If your child lets you know that his heels are hurting, schedule a doctor's appointment. Your family doctor may or may not refer you to a podiatrist. Treatment for Sever's Disease typically consists
of one or more of the following steps. Reducing physical activity. Because Sever's Disease appears to be most common in athletic children, reducing exercise periods will relieve pressure on the heel
bones, thereby reducing pain. Your doctor may recommend that your child take a complete break from athletic activity for a set amount of time. Icing the heel bones can help to lower both inflammation
and pain levels. Use a cold pack or wrap ice in a towel and apply it to the heels. A new exercise regimen that involves simple stretches designed to lengthen the calf muscles and tendons. Your doctor
may prescribe the use of orthotic shoe inserts that will assist your child in maintaining a good level of physical activity. HTP Heel Seats may be an excellent option and have been purchased by many
parents as an effective aide for children suffering from Sever's Disease. Read about HTP Heel Seats here and ask your doctor if they are right for your child's unique case. In extreme cases, a doctor
may recommend a plaster cast or boot, but typically only if other less cumbersome solutions fail to reduce pain. Some doctors may prescribe anti-inflammatory medications. Never give these to a child
yourself, without first seeking a doctor's advice. Some medications carry the risk of serious side effects for children. Only give medications if specifically prescribed your child's physician.