Sever’s disease, also known as calcaneal apophysitis, is chronic inflammation of the heel growth plate. This causes the child to complain of heel pain, limp, and resort to walking on the toes.
What is Sever’s disease?
Calcaneal apophysitis is any injury to the child’s developing foot structure, which is an inflammation of the child’s heel growth plate due to repetitive stress or muscle strain.
What causes the child’s heel pain?
The heel pain occurs from the position of the foot. With Sever’s disease, the heal pain is worsened by overuse injuries and tendo-achilles bursitis. The cause of Sever’s disease is not really clear, but experts believe the pain is the result of repeated minor trauma from high-impact activities, such as jumping and running (soccer, gymnastics, and soccer).
What are the symptoms of Sever’s disease?
Sever’s disease causes tenderness and pain in the bottom and back of the heel, which is worse with standing and walking. The heel is also painful to touch. The symptoms most often occur in both feet, but the condition an only affect one heel. Other symptoms include redness and swelling of the heel region, which is worsened by activities.
How is Sever’s disease treated?
Some options for treating Sever’s disease include:
- Orthotics and special shoes – To alleviate the symptoms of Sever’s disease, the child may require special shoes, such as those with a cushion in the foot-bed, which offers support to the outsole and shock absorption in the heel region. When the child is running or jumping, the inserts are work to reduce the impact on the heel and strain on the muscle and bone structures of the child’s feet.
- Activity restrictions – This includes reduced activity, wearing shoes, and avoiding high-impact activities. Rest from sporting activities improves and alleviates pressure on the heel.
- Ice pack – To alleviate pain, an ice pack is used (20 minutes on and off), which reduces swelling and inflammation.
- Exercises – Stretching and strengthening exercises help improve flexibility and strength of tendons, muscles, and structures of the leg and heel.
- Anti-inflammatory drugs – Medications used to alleviate pain and inflammation include ketoprofen, ibuprofen, and naproxen.
- Iontophoresis – Electromotic drug administration (iontophoresis) is the process of using a small laser to administer medication through the skin.
How common is Sever’s disease?
Sever’s diease is the most common cause of heel pain among older children. It is estimated to occur along with 5.5% of all foot/heel injuries in people less than 20 years old. Sever’s disease is most often seen among athletic children and boys 10-12 years, entering early puberty.
How is Sever’s disease diagnosed?
Sever’s disease is diagnosed using x-rays, physical examination, and symptom evaluation. A diagnostic tool used to evaluate the internal structures (ultrasound) will allow the doctor to assess for heel inflammation.
What are the complications of Sever’s disease?
Sever’s disease is assocated with calcaneal apophyseal fracture, which is more common among physically active teens. In addition, the apophysis can be displaced and require repair.