Sever's disease, also known as calcaneal apophysitis, is an inflammatory condition of the growth plate of the heel (calcaneus). Sever's disease is seen during periods ofSever's_Disease_x-ray active
bone growth, particularly between the ages of 10 and 14 years old. Sever's disease is a self limiting condition, meaning that all cases of Sever's disease will disappear once bone growth is finalized
and the growth plate of the heel closes. Skeletal maturity and closure of the growth plate occurs for most children at 15-16 years of age. The onset of Sever's Disease is insidious and found more in
boys than girls.
Your child is most at risk for this condition when he or she is in the early part of the growth spurt in early puberty. Sever's disease is most common in physically active girls 8 years to 10 years
of age and in physically active boys 10 years to 12 years of age. Soccer players and gymnasts often get Sever's disease, but children who do any running or jumping activity may also be at an
increased risk. Sever's disease rarely occurs in older teenagers because the back of the heel has typically finished growing by 15 years of age.
Activity-related pain that occurs on the back of the heel, where the Achilles tendon attaches on to the heel bone. Tenderness, pain & swelling on the heel bone. Difficulty walking or walking with
a limp or on tiptoes.
Sever?s disease can be diagnosed based on the symptoms your child has. Your child?s doctor will conduct a physical examination by squeezing different parts of your child?s foot to see if they cause
any pain. An X-ray may be used to rule out other problems, such as a broken bone or fracture.
Non Surgical Treatment
Treatment of Sever's disease will depend upon the severity of the condition. Parents can assist with the treatment of Sever's disease by making sure their children reduce physical activity until some
of the pain subsides. Losing weight can also help reduce pressure on the heel. It is important to consult a doctor if the pain persists. A physician may recommend flexibility exercises, custom shoe
inserts, or anti-inflammatory medication. In some cases, a splint or cast may be necessary to immobilize the foot and give it a chance to heal. Most cases of Sever's disease will resolve by the age
of 16, when growing subsides. Fortunately, there are no known long-term complications associated with the disease.
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