Sever's disease is a mild traction injury of the heel. There is an apophysitis at the point of the insertion of the Achilles tendon. This condition is treated by raising the heel of the shoe a
little, calf-stretching and avoiding strenuous activities for a few weeks.
Severs disease is often associated with a rapid growth spurt. As the bones get longer, the muscles and tendons become tighter as they cannot keep up with the bone growth. The point at which the
achilles tendon attaches to the heel becomes inflamed and the bone starts to crumble (a lot like osgood schlatters disease of the knee). Tight calf muscles may contribute as the range of motion at
the ankle is reduced resulting in more strain on the achilles tendon. Sever's disease is the second most common injury of this type which is known as an apophysitis.
Sever condition causes pain at the back of the heel. The pain is increased with plantar flexion of the ankle (pushing down with the foot as if stepping on the gas), particularly against resistance.
Sever condition also causes tenderness and swelling in the area of the pain.
In Sever's disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or
she runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that
your child's heel tendons have become tight.
Non Surgical Treatment
Decreasing or stopping sport is necessary until the pain reduces. Let pain be your guide, as it decreases you can slowly return to all activities. To help settle inflammation use an ice pack or rub
an ice cube over the
painful area for 5 minutes daily whilst pain persists. Wearing supportive trainers during the day can help to soften the impact of walking on the heel. Encourage a normal pattern of walking. Complete
the stretches below every day and before and after activity until your symptoms settle.
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