Sever's disease is a common cause of heel pain in growing kids, especially those who are physically active. It usually occurs during the growth spurt of adolescence, the approximately 2-year period
in early puberty when kids grow most rapidly. This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys. Sever's disease rarely occurs in older teens because
the back of the heel usually finishes growing by the age of 15, when the growth plate hardens and the growing bones fuse together into mature bone. Sever's disease is similar to Osgood-Schlatter
disease, a condition that affects the bones in the knees.
This condition most commonly occurs due to repetitive or prolonged activities placing strain on the heel's growth plate, typically during a period of rapid growth. These activities (or sports)
usually involve excessive walking, running, jumping or hopping. Severs disease may also be more likely to occur following a poorly rehabilitated sprained ankle, in patients with poor foot
biomechanics or those who use inappropriate footwear. In young athletes, this condition is commonly seen in running and jumping sports, such as football, basketball, netball and athletics.
The patient complains of activity related pain that usually settles with rest. On Examination the heel bone - or calcaneum - is tender on one or both sides. The gastrocnemius and soleus muscles (calf
muscles) may be tight and bending of the ankle might be limited because of that. Foot pronation (rolling in) often exacerbates the problem. There is rarely anything to see and with no redness or
swelling and a pain that comes and goes mum and dad often wait before seeking advice on this condition. The pain may come on partway through a game and get worse or come at the end of the game.
Initially pain will be related only to activity but as it gets worse the soreness will still be there the next morning and the child might limp on first getting up.
The x-ray appearance usually shows the apophysis to be divided into multiple parts. Sometimes a series of small fragments is noted. Asymptomatic heels may also show x-ray findings of resporption,
fragmentation and increased density. But they occur much less often in the normal foot. Pulling or ?traction? of the Achilles tendon on the unossified growth plate is a likely contributing factor to
Sever?s disease. Excessive pronation and a tight Achilles and limited dorsiflexion may also contribute to the development of this condition.
Non Surgical Treatment
Orthotics, The orthotics prescribed 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.