Sever's disease, or calcaneal apophysitis, is a common cause of heel pain in patients whose bones are still growing; however, it is not really a disease. The pain is caused by stress at the point
where the Achilles tendon meets tissue called the plantar fascia on the growth plate (apophysis) of the heel bone (calcaneus). Sever's affects boys more often than girls. Boys are most often affected
at age 12, and girls at age 9, though Sever's is typically seen in children and adolescents between the ages of 7 and 15.
Sever?s disease is caused by repetitive tension and/or pressure on the growth center of the heel. Running and jumping place a large amount of pressure on the heels and can cause pain. Children with
Sever?s may limp or have an altered gait due to the pain. Risk factors for Sever's include tight calf muscles, weak ankle muscles, and alignment abnormalities at the foot and ankle. Sever?s can also
result from wearing shoes without sufficient heel padding or arch support.
Symptoms of calcaneal apophysitis may include Pain in the back or bottom of the heel, Limping, Walking on toes, Difficulty running, jumping, or participating in usual activities or sports, Pain when
the sides of the heel are squeezed.
A Podiatrist can easily evaluate your child?s foot, lower limbs and muscular flexibility, to identify if a problem exists. If a problem is identified, a simple treatment plan is put in place. Initial
treatment may involve using temporary padding and strapping to control motion or to cushion the painful area and based on the success of this treatment, a long-term treatment plan will be put in
place. This long-term treatment plan may or may not involve Foot Supports, Heel Raises, muscle stretching and or strengthening.
Non Surgical Treatment
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