Sever's Disease (Heel pain in children)

What is Sever's Disease?

Sever's Disease (Calcaneal Aphophysitis) is not a disease, but a repetitious strain injury common in children between the ages of 8 and 14 years old.

It is a common cause of heel pain, particularly in the very active child. Patients with Sever's disease complain of pain in the bottom surface region of the back of the heel. This is where the growth plate is located, and is not fully developed or calcified in a child's foot.

Cause

Sever's Disease is a repetitive strain injury caused by the following:

1. High impact injury activities and sport like netball, football, soccer, hockey, basketball, running, jumping and tennis
2. Tight calf muscles
3. Poor mechanics, structure and function of the foot
4. Excessive pronation
5. Rapid growth spurt

The above causes tension, inflammation and pain where the Achilles tendon inserts onto the calcaneus (Back/bottom surface of the heel bone).

It is important that this problem is treated and monitored until the growth plate ossifies in the heel. This could occur between the ages of 14 and 16 years of age.

In extreme cases the growth plate can become separated from the calcaneus.

Signs and Symptoms

1. Pain in the bottom surface and at the back of the heel
2. Extreme pain when the child places their heel on the ground
3. The pain is aggravated when running or jumping on hard surfaces
4. The pain is reduced when the child walks or runs on their toes

Treatments

• Orthotics - The orthotics prescribed and designed by the podiatrists at Heel and Arch pain Clinic (affiliated with Beyond Podiatry) are made to align the foot in its correct foot posture. This will reduce stress and force at the site of the growth plate of the heel bone
• Rest and Ice the heel 20 minutes before and after sporting activity
• Calf muscle stretching exercises