Sever's disease (calcaneal apophysitis) is a common cause of heel pain, particularly in physically active young people who are about to begin puberty. The cause is uncertain, but it is thought that
the long calf bones of the leg grow faster than the surrounding muscle and soft tissue, causing the Achilles tendon to pull uncomfortably tight. 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.
The heel bone grows faster than the ligaments in the leg. As a result, muscles and tendons can become very tight and overstretched in children who are going through growth spurts. The heel is
especially susceptible to injury since the foot is one of the first parts of the body to grow to full size and the heel area is not very flexible. Sever?s disease occurs as a result of repetitive
stress on the Achilles tendon. Over time, this constant pressure on the already tight heel cord can damage the growth plate, causing pain and inflammation. Such stress and pressure can result from
sports that involve running and jumping on hard surfaces (track, basketball and gymnastics). Standing too long, which puts constant pressure on the heel. Poor-fitting shoes that don?t provide enough
support or padding for the feet. Overuse or exercising too much can also cause Sever?s disease.
The most common symptoms of Sever?s involves pain or tenderness in one or both heels. This pain usually occurs at the back of the heel, but can also extend to the sides and bottom of the heel. A
child with Sever?s may also have these common problems, Heel pain with limping, especially after running. Difficulty walking, Discomfort or stiffness in the feet upon awaking. Swelling and redness in
the heel, Symptoms are usually worse during or after activity and get better with rest.
This condition is self limiting, it will go away when the two parts of bony growth join together, this is natural. Unfortunately, Sever's disease can be very painful and limit sport activity of the
child while waiting for it to go away, so treatment is often advised to help relieve it. In a few cases of Sever's disease, the treatment is not successful and these children will be restricted in
their activity levels until the two growth areas join, usually around the age of 16 years. There are no known long term complications associated with Sever's disease.
Non Surgical Treatment
First, your child should cut down or stop any activity that causes heel pain. Apply ice to the injured heel for 25 minutes three times a day. Your child should not go barefoot. If your child has
severe heel pain, ibuprofen (Advil) will help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should
do these stretches five times each, two or three times a day. Each stretch should be held for 20 seconds. Your child also needs to do exercises to strengthen the muscles on the front of the shin. To
do this, have your child stand facing a wall to stretch the calves and the heel cord. Place one foot a shoulder?s width in front of the other, both feet facing the wall. The front knee is bent and
the back knee is straight during the calf stretch. Then have your child push against the wall and feel the stretch in his or her back leg. To stretch out the heel cord, have him or her stay in the
same position and bend the back knee. Repeat three times. Practice this stretch twice daily.
After the painful symptoms of Sever's disease have gone away, it is important to continue stretching the heel, particularly before a vigorous exercise, and wearing good supportive shoes fitted with
children's arch supports. This will prevent heel pain recurrence until the child's heel is fully developed and less prone to injury.