Sever’s disease, medically known as calcaneal apophysitis, is a common cause of heel pain in growing children and adolescents, particularly those who are physically active. Despite its name, Sever’s disease is not an actual disease but rather a growth-related condition that can cause significant discomfort and hinder athletic performance.
What is Sever’s Disease?
Sever’s disease occurs when the growth plate in the heel (calcaneus) becomes inflamed. The growth plate is a soft area of cartilage located at the back of the heel, where new bone forms as a child grows. This area is more vulnerable to injury than the surrounding bone and is prone to inflammation due to repetitive stress or overuse.
Who Does Sever’s Disease Affect?
Sever’s disease primarily affects children and adolescents between the ages of 8 and 14, coinciding with periods of rapid growth spurts. It is particularly common in physically active kids who engage in sports that involve running, jumping, or activities that place considerable stress on the heels, such as soccer, basketball, track, and gymnastics. Boys are more frequently affected than girls, likely due to higher participation rates in high-impact sports.
Symptoms of Sever’s Disease
The hallmark symptom of Sever’s disease is heel pain that typically worsens with physical activity and improves with rest. Other common symptoms include:
- Swelling and redness around the heel.
- Tenderness at the back of the heel when it is squeezed.
- Stiffness and difficulty walking, especially in the morning.
- Limping or walking on tiptoes to avoid putting pressure on the heel.
Diagnosis
Diagnosis of Sever’s disease is primarily clinical, based on a detailed history and physical examination. A podiatrist will inquire about the child’s symptoms, activity level, and any recent growth spurts. During the examination, the doctor may perform a squeeze test, gently compressing the sides of the heel to elicit pain. While X-rays are not typically necessary, they may be used to rule out other conditions, such as fractures or bone abnormalities.
Treatment Options for Sever’s Disease
The good news is that Sever’s disease is a self-limiting condition, meaning it resolves on its own once the child’s growth plate fully matures. However, managing symptoms and preventing further injury is crucial for maintaining an active lifestyle. Here are several effective treatment strategies:
1. Rest and Activity Modification
Reducing or temporarily stopping activities that cause heel pain is the first step in treatment. Encourage your child to take breaks from high-impact sports and engage in low-impact activities like swimming or cycling during the recovery period.
2. Ice Therapy
Applying ice to the affected heel can help reduce inflammation and alleviate pain. Use an ice pack wrapped in a towel for 15-20 minutes several times a day, especially after physical activity.
3. Stretching and Strengthening Exercises
Stretching exercises for the calf muscles and Achilles tendon can help relieve tension on the heel. Strengthening the foot and leg muscles also provides better support and reduces strain on the growth plate. A podiatrist or physical therapist can recommend specific exercises tailored to your child’s needs.
4. Footwear and Orthotics
Ensure your child wears well-fitting, supportive shoes with good cushioning. Avoid worn-out shoes and opt for those designed for athletic activities. Custom or over-the-counter orthotic inserts can provide additional support and help distribute pressure more evenly across the foot.
5. Pain Relief Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help manage pain and reduce inflammation. Always consult a healthcare professional before giving any medication to your child.
6. Heel Cups or Pads
Soft heel cups or pads placed inside the shoes can cushion the heel and reduce impact during activities, providing added comfort.
7. Physical Therapy
In some cases, a podiatrist may recommend physical therapy to help with pain management, stretching, and strengthening exercises. Physical therapy can also educate children on proper techniques to avoid further injury.
Preventing Sever’s Disease
Preventative measures can help minimize the risk of developing Sever’s disease. Encourage your child to:
- Wear appropriate, supportive footwear for their activities.
- Gradually increase activity levels rather than jumping into intense sports suddenly.
- Incorporate proper warm-up and cool-down routines, including stretching exercises.
- Stay hydrated and maintain a healthy diet to support overall growth and bone health.
Sever’s disease, though painful, is a temporary condition that can be effectively managed with appropriate care and modifications to physical activity. By understanding the symptoms and following the recommended treatment strategies, parents and young athletes can navigate this condition with confidence, ensuring a swift return to pain-free sports and daily activities. If your child experiences persistent heel pain, consult a us so Dr. Wright can help give a proper diagnosis and personalized treatment plan.