Sever?s disease (sometimes called Sever disease) is a common cause of heel pain, particularly in the young and physically active. It usually develops just before puberty. Boys are slightly more prone
to this condition than girls. Physiotherapy can help manage the symptoms of Sever?s disease so that the young person can continue to take part in physical activity. Another name for Sever?s disease
is calcaneal apophysitis.
A child is most at risk for this condition when he or she is in the early part of the growth spurt in early puberty. Sever?s disease is most common in physically active girls eight to ten years old
and in physically active boys ten to twelve years old. Soccer players and gymnasts often get Sever?s disease, but children who do any running or jumping activity may be affected. Sever?s disease
rarely occurs in older teenagers, because the back of the heel has finished growing by the age of fifteen.
Pain in the lower calf and heel area which may be worse when applying pressure either side. Pain worse on activity especially those involving running or jumping. In severe cases this may cause the
child to limp when walking. One or both heels affected.
Radiography. Most of the time radiographs are not helpful because the calcaneal apophysis is frequently fragmented and dense in normal children. But they can be used to exclude other traumas.
Ultrasonography. could show the fragmentation of secondary nucleus of ossification of the calcaneus in severs?s disease. This is a safe diagnostic tool since there is no radiation. This diagnostic
tool can also be used to exclude Achilles tendinitis and/or retrocalcaneal bursitis.
Non Surgical Treatment
Initially, Sever?s Disease is treated with rest, anti-inflammatory medication and softer shoes. Ice followed by heat is a common practice and heel cup orthotics have worked wonders for our young
patients in the past. It can take anywhere from a few weeks to a year for these growth plates to naturally close - at which point Sever?s Disease disappears. Even though the condition does heal on
its own, athletes are encouraged to seek treatment, rather than push through the pain. Simply ?dealing with it? and continuing to play sports despite the injury could lead to an impaired gait, a
strained hip or a knee injury. Stretches to strengthen the leg muscles, leg compression wraps and over-the-counter acetaminophen or ibuprofen are also recommended treatments. In very rare cases, a
podiatrist may recommend wearing a cast for two to twelve weeks.
Sever's disease may be prevented by maintaining good joint and muscle flexibility in the years leading up to, and during, their growth spurts (eg girls 8 to 10, boys 10 to 12). Foot arch problems
such as flat feet should be addressed after the age of five if they don't appear to be self-correcting. If you are concerned, please ask your health practitioner. The most important factor is the
amount of weight-bearing exercise your child is currently performing.