Calcaneal Apophysitis (Sever's Disease)
Care-Treatment-Services
January 18, 2025
Calcaneal Apophysitis (Sever's Disease)
Calcaneal apophysitis, commonly referred to as Sever's disease, is a condition that primarily affects active children and adolescents during their growth spurts. This guide provides a comprehensive overview of Sever's disease, covering its causes, symptoms, diagnosis, and effective management strategies. By understanding this often misunderstood heel condition, parents, caregivers, and young individuals can better recognize, address, and prevent its occurrence.
Navigating the Basics of Sever's Disease
Defining Calcaneal Apophysitis
Sever's disease is an inflammation of the growth plate in the heel bone (calcaneus). This growth plate, known as the apophysis, serves as a connection point for tendons and is particularly susceptible to stress during rapid growth phases.
Occurrence During Growth Spurts
Sever's disease most commonly affects pre-adolescents and adolescents, typically between the ages of 8 and 15 in girls and 10 and 17 in boys. It is often associated with increased physical activity during growth spurts.
Causes and Risk Factors
Overuse and Repetitive Stress
Repetitive stress and overuse of the heel bone during activities involving running or jumping are primary contributors. These stresses lead to inflammation of the growth plate.
Physical Growth and Development
Rapid growth during adolescence can create an imbalance between muscle strength and bone growth, leaving the heel more vulnerable to stress.
Sports Participation
Activities such as soccer, basketball, and gymnastics increase the risk of Sever's disease due to the repetitive impact and strain they place on the heel.
Recognizing Symptoms of Sever's Disease
Heel Pain
Heel pain, typically localized at the back of the heel, is the most prominent symptom. This pain often worsens after physical activity and may interfere with daily activities.
Swelling and Redness
Inflammation can cause localized swelling and redness around the heel, and the area may feel warm to the touch.
Limping or Walking on Toes
Children with Sever's disease may walk on their toes or develop a limp to avoid putting pressure on the affected heel.
Diagnosing Sever's Disease
Clinical Examination
Diagnosis usually begins with a thorough clinical examination, including a review of symptoms and a physical assessment of the foot.
Imaging Studies
X-rays may be used to rule out other causes of heel pain, although they are not always necessary for diagnosing Sever's disease.
Differential Diagnosis
Conditions such as plantar fasciitis and Achilles tendonitis can present similar symptoms. Accurate diagnosis ensures appropriate treatment.
Treatment Strategies for Sever's Disease
Rest and Activity Modification
Reducing physical activity and resting the affected foot are key components of management. Temporary cessation of high-impact sports may be necessary.
Ice and Anti-Inflammatory Medications
Applying ice to the heel and using over-the-counter anti-inflammatory medications can help alleviate pain and reduce swelling.
Stretching and Strengthening Exercises
Physical therapy focusing on calf stretches and strengthening exercises can address muscle imbalances, promoting flexibility and overall foot health.
Supportive Footwear and Orthotics
Proper Shoe Selection
Supportive footwear with cushioning and arch support helps reduce heel impact during activities.
Orthotic Inserts
Custom or over-the-counter orthotic inserts can redistribute pressure, providing additional support and alleviating strain on the growth plate.
Gradual Return to Physical Activities
Monitoring Symptoms
A gradual return to physical activities is essential. Symptoms should be closely monitored, and any recurrence of pain requires prompt attention.
Cross-Training
Low-impact activities, such as swimming or cycling, can help maintain physical fitness while minimizing heel stress.
When Surgical Intervention Is Considered
Rare Occurrence
Surgical intervention is extremely rare and is considered only when conservative treatments fail and pain persists.
Consultation with Specialists
Chronic or severe cases may require evaluation by pediatric orthopedic specialists to explore alternative treatment options.
Preventive Measures for Sever's Disease
Monitoring Growth and Development
Awareness of a child’s growth patterns allows for early identification of risk factors and proactive management.
Proper Warm-Up and Conditioning
Incorporating warm-up routines and conditioning exercises helps prepare muscles and tendons, reducing injury risk.
Education and Communication
Educating caregivers, coaches, and young athletes about Sever's disease promotes early recognition and timely intervention.
Conclusion
Sever's disease is a temporary and treatable condition that affects growing children and adolescents. By understanding its causes, recognizing symptoms, and implementing appropriate management strategies, caregivers can ensure the well-being of young individuals experiencing heel pain. A combination of rest, supportive measures, and preventive strategies can effectively manage Sever's disease, allowing children to resume their active lifestyles with minimized discomfort and enhanced foot health.
Sources:
Disclaimer: The information on this website is provided for educational purposes only and is not medical advice. Always consult a licensed medical provider for diagnosis and treatment recommendations. If you are experiencing a medical emergency, call 911 or visit the nearest emergency room. Neither the author nor this website guarantees the accuracy of information linked to third-party sources.
Who we are: For trusted podiatric care in Orlando, Lake Mary, Altamonte Springs, Longwood, Apopka, turn to Dr. Carli Hoover and Dr. Sean Griffin at Central Florida Foot and Ankle Institute - a physician owned-operated group. From sports injuries to general foot health, our team offers specialized treatments tailored to your needs. Contact us now at 407-307-0006 to schedule your consultation and take the first step toward healthier feet!