What is Sever’s disease?

Sever’s disease, also known as calcaneal apophysitis, is a common cause of heel pain in children who are growing rapidly. It is not a serious condition, but it can be very painful and interfere with physical activities.

Sever’s disease occurs when the growth plate in the heel bone becomes inflamed due to repeated stress or pressure. The growth plate is a layer of cartilage that allows the bone to grow in length and width. It is located at the back of the heel, where the Achilles tendon attaches to the bone.

What causes Sever’s disease?

Sever’s disease is more common in children who are active and participate in sports that involve running, jumping, or changing direction quickly, such as soccer, basketball, or gymnastics.

These activities can put a lot of strain on the heel and cause microtrauma to the growth plate. Other factors that can increase the risk of Sever’s disease include:

Having tight calf muscles or Achilles tendons

Having flat feet or high arches

Being overweight or obese

Wearing shoes that do not fit well or provide enough cushioning and support

Having a growth spurt

What are the symptoms of Sever’s disease?

The main symptom of Sever’s disease is pain in one or both heels, especially during or after physical activity. The pain may be worse when the child stands on tiptoe or pushes off the ground. The heel may also be swollen, red, or tender to the touch.

The child may limp or walk with a different gait to avoid putting pressure on the heel. The pain usually lasts for a few weeks or months and then disappears when the growth plate closes and the bone stops growing.

How is Sever’s disease diagnosed?

Sever’s disease can be diagnosed by a doctor based on the child’s medical history, physical examination, and symptoms.

The doctor may ask about the child’s activity level, growth pattern, and shoe wear. The doctor may also squeeze the sides of the heel or ask the child to stand on tiptoe or hop on one foot to check for pain and inflammation.

X-rays or other imaging tests are usually not needed, unless the doctor suspects another condition, such as a fracture, infection, or tumor.

How is Sever’s disease treated?

The treatment of Sever’s disease aims to relieve the pain and inflammation and allow the growth plate to heal. The treatment may include:

Resting the heel and avoiding activities that cause or worsen the pain

Applying ice to the heel for 15 to 20 minutes several times a day

Taking over-the-counter pain relievers, such as ibuprofen or acetaminophen, as directed by the doctor

Stretching and strengthening the calf muscles and Achilles tendons

Wearing shoe inserts, heel pads, or heel cups to reduce the pressure on the heel

Wearing shoes that fit well and have good cushioning and support

Gradually resuming physical activity after the pain subsides, and avoiding overdoing it

How can Sever’s disease be prevented?

Sever’s disease can be prevented by following some simple steps, such as:

Warming up and cooling down before and after exercise

Wearing appropriate shoes for the activity and changing them when they wear out

Avoiding running or jumping on hard or uneven surfaces

Maintaining a healthy weight and eating a balanced diet

Having regular check-ups with the doctor to monitor the child’s growth and development