Sever's disease is a condition characterized by pain in one or both heels with walking. The pain is caused by shortening of the heel-cord. It usually affects children between the ages of 10 and 13
years old. During this phase of life, growth of the bone is taking place at a faster rate than the tendons. Sever's disease is also called calcaneal apophysitis.
Sever condition is caused by sprain injury where the Achilles tendon attaches to the calcaneus bone at the back of the heel. Sever condition occurs in adolescent or older children, particularly
active boys. It can be very painful. It is one of those conditions commonly referred to as "growing pains." Patients are evaluated for signs of conditions that can mimic Sever condition, such as
ankylosing spondylitis and other forms of arthritis. Usually Sever condition is self-limited; that is, it disappears as the child ages.
Pain is usually related to activity levels. In most cases the posterior aspect of the calcaneus will be tender. Checking both the medial and lateral aspects of the posterior portion of the growth
plate will often show tenderness. Occasionally, the plantar aspect may be tender or both of these locations may be found to be tender. Frequently the Achilles tendon is tight and there may have been
a recent increase in activity. The factors contributing to this disorder are similar to those causing plantar fasciitis, but a tight Achilles tendon appears to be a greater contributor than
Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as
it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.
Non Surgical Treatment
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel.
Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and
inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a
cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence
of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle
To prevent Sever's Disease, fit your child with kid's shoes with good cushioning in the footbed, shock absorption in the heel, and support in the outsole. Make sure children wear supportive shoes,
especially when they're running and jumping, to reduce the impact on the heel and strain on the developing bone and muscle structure of a kids' feet. Children's arch supports and heel cups
comfortably support the foot and encourage healthy alignment while your child runs or walks.