Sever?s disease, also known as calcaneal apophysitis, is an inflammation of the heel?s growth plate. It is commonly seen in active children between the ages of 8 and 15 years. These children present
with pain when walking, running and jumping. Observable inflammation may or may not be present and parents may often notice their child limping or favouring a limb during or after sports.
Sever?s Disease is thought to be caused by several reasons. Growth spurts. The muscles and tendons become tight due to rapid bone growth. Overuse. Sever?s Disease can also occur in children who are
athletically active and overwork his or her muscles. Some physicians are beginning to caution parents about checking their children?s shoes to make sure they fit well and do not pinch or put undue
pressure on the child?s feet. Pronation can also bring on Sever?s Disease.
The condition can be quite disabling and tends to affect those who are very busy with sporting activities. In the initial stages of the condition, most children displaying signs of Severs disease
will tend to hobble or limp off the sports field or court and complain of sore heels near the end of activity. As the condition progresses, children may complain of pain during activity and in severe
cases prior to sporting activities. Kids heel pain can be quite discouraging for active children but, early treatment can resolve this type of foot pain in children very quickly.
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
If the child has a pronated foot, a flat or high arch, or another condition that increases the risk of Sever's disease, the doctor might recommend special shoe inserts, called orthotic devices, such
as heel pads that cushion the heel as it strikes the ground, heel lifts that reduce strain on the Achilles tendon by raising the heel, arch supports that hold the heel in an ideal position. If a
child is overweight or obese, the doctor will probably also recommend weight loss to decrease pressure on the heel. The risk of recurrence goes away on its own when foot growth is complete and the
growth plate has fused to the rest of the heel bone, usually around age 15.