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Sever’s disease, also known as calcaneal apophysitis, is a common cause of heel pain in growing children, particularly physically active children.
This condition is not an actual disease but rather an overuse injury when the growth plate (a soft area of developing tissue at the end of a long bone) in the heel becomes inflamed.
In growing children, Sever’s disease involves inflammation of the growth plate (apophysis) on the back and bottom of the heel bone (calcaneus).
Understanding Sever’s helps recognize and manage this common pediatric heel condition.
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Few symptoms of Sever’s Disease are as follows:
Symptoms are typically only present during or after exercise, unlike in Achilles tendinitis or plantar fasciitis. The pain subsides once the growth plate finishes maturing.
Sever’s disease most commonly occurs during the growth spurt of adolescence, around the ages of 8 to 15 for girls and 10 to 17 for boys. During this time, the heel bone (calcaneus) can grow faster than the muscles, tendons, and ligaments in the leg, which can cause them to become tight and overstretched. This can put too much stress on the heel’s growth plate and lead to inflammation and pain – a condition known as Sever’s disease.
Factors that can increase a child’s risk of developing Sever’s disease include:
Sudden increases in activity levels and sports participation make the disease more likely to occur.
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Some of the risk facts of sever’s disease are as follows;
These modifiable factors help identify which young athletes are most at risk for developing Sever’s.
Sever’s disease can be diagnosed through:
There are no definitive diagnostic tests. Diagnosis is based on typical symptoms plus age and activity history.
In most cases, Sever’s disease resolves on its own once the child’s rapid growth ends. However, managing symptoms effectively is essential to prevent any interruption in the child’s ability to participate in physical activities. If your child is experiencing heel pain, consult a healthcare professional for a proper evaluation and treatment plan.
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Treatment focuses on reducing stress on the irritated growth plate to allow it to heal:
With compliance and rest from aggravating activities, Sever’s disease generally resolves fully in growing kids. Surgery is never needed.
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Methods to help prevent Sever’s disease:
Being proactive and limiting high-impact sports helps prevent recurrence.
Sever’s disease itself does not cause any long-term damage or complications with proper management. Symptoms disappear once the growth plates ossify, and the heel bone matures during adolescence.
Achilles tendinitis, plantar fasciitis or heel spurs may develop later in life if predisposing foot alignment issues occur. Maintaining good flexibility, strength, and foot mechanics helps prevent heel pain as adults. Sever’s disease does not recur after skeletal maturity is reached.
Sever’s disease is often triggered by repetitive stress from sports involving running and jumping during rapid growth in childhood and adolescence. Tight calf muscles and poorly aligned feet can also contribute.
Sever’s disease symptoms typically resolve within 6 to 12 months with proper treatment as the growth plate finishes maturing. Modifying activities helps speed recovery.
Sports aggravating heel pain should be avoided until Sever’s disease resolves to prevent recurrence. Low-impact activities or substituting swimming/cycling for running sports can allow participation.
Sever’s disease is treated with rest, anti-inflammatories, ice, orthotics, heel pads, calf stretching, footwear modifications, and activity limitations until the growth plate finishes developing. Physical therapy also helps.
Sever disease, also known as calcaneal apophysitis, is a common cause of pain in the heel in children. It occurs when there is inflammation in the growth plate of the heel bone.
The most common symptom of Sever Disease is heel pain, especially in the back of the heel. The pain may be worse during activities that involve running or jumping.
The exact cause of Sever Disease is still unknown. However, it is believed to be caused by the stress placed on the heel’s growth plate due to activities like running or jumping on hard surfaces.
Diagnosis of Sever Disease is usually based on a physical examination by a podiatrist or another health professional. Sometimes, an X-ray may be taken to rule out other possible causes of pain in the heel.
The treatment for Sever Disease involves reducing the stress placed on the heel. This may include rest, heel lifts or inserts, and supportive shoes. Physical therapy exercises may also be recommended to strengthen the calf muscles and tendons.
Sever Disease is a self-limiting condition, which means it usually resolves on its own once the growth plate in the heel has closed. The state typically lasts for a few months to a year but can vary in duration.
