Understanding Sever's Disease

Sever's Disease, or calcaneal apophysitis, is a common heel condition seen in children aged 8 to 14. It occurs when the growth plate at the back of the heel bone (calcaneus) becomes inflamed due to stress from physical activity. This condition typically develops during periods of rapid growth, especially when bones grow faster than muscles and tendons.

Causes of Sever's Disease

The primary cause of Sever's Disease is the overuse of the heel bone during periods of rapid growth. As children become more active, the muscles and tendons struggle to keep up with the fast-growing bones, leading to strain on the growth plate.

• Adolescent Onset: Sever's Disease is most common in children and adolescents aged 8-14, when the heel bone is still developing.

• Physical Activity: Activities such as running, jumping, and other high-impact sports can trigger inflammation in the growth plate.

• Improper Footwear: Wearing shoes that do not provide adequate support can contribute to foot stress and increase the risk of Sever's Disease.

Recognizing Symptoms and Signs

The hallmark symptom of Sever's Disease is pain at the back of the heel. The pain may worsen after physical activities like running or jumping. Other signs of the condition include:

• Heel Pain: Pain, typically at the back or sides of the heel, which intensifies during or after physical activity.

• Limping or Walking on Toes: Children with Sever's Disease may limp or walk on their toes to avoid putting pressure on the painful heel.

• Swelling: Inflammation around the heel may accompany pain.

Diagnosis and Assessment

Sever's Disease is diagnosed through a clinical evaluation, where a healthcare professional will assess the child’s symptoms, activity level, and medical history. In some cases, X-rays may be recommended to rule out other causes of heel pain and confirm inflammation of the growth plate.

• Clinical Evaluation: The doctor will assess the range of motion, flexibility, and tenderness in the heel area.

• X-rays: To rule out other conditions and confirm inflammation of the growth plate.

Effective Management Strategies

Rest and Activity Modification

Rest is the cornerstone of managing Sever's Disease. Limiting high-impact activities, such as running and jumping, allows the growth plate to heal.

• Activity Modification: Children should avoid sports or activities that put excessive strain on the affected heel, focusing on low-impact activities instead.

Supportive Footwear

Wearing shoes with proper arch support and cushioning can reduce pressure on the heel and alleviate pain. Avoiding shoes with insufficient support is crucial.

• Proper Footwear: Shoes that offer adequate heel support and cushioning can significantly reduce symptoms.

• Avoid High Heels: Shoes with high heels or poor arch support should be avoided to prevent further strain.

Ice and Anti-Inflammatory Medications

Applying ice to the affected area can reduce swelling and inflammation. NSAIDs, such as ibuprofen, may be recommended to manage pain and inflammation under medical supervision.

• Ice: Apply ice for 15-20 minutes to reduce swelling and inflammation.

• NSAIDs: Over-the-counter medications can help control pain and swelling.

Physical Therapy and Stretching

Gentle stretching exercises can help maintain flexibility and reduce tension in the calf muscles, which may relieve stress on the heel.

• Calf Stretching Exercises: Stretching the calf muscles can help alleviate tightness and support the healing process.

• Strengthening Exercises: Strengthening the muscles surrounding the foot and ankle can improve stability and reduce future strain.

Supporting Emotional Well-being

Sever's Disease can affect a child's ability to participate in sports and activities. It is important to provide emotional support and educate the child and their parents about the condition to foster understanding and adherence to treatment plans.

• Psychosocial Support: Supporting children emotionally helps them manage the frustration and limitations caused by this condition.

Preventing Recurrence and Long-Term Impact

Once the symptoms subside, it is important to gradually return to normal activities. Proper warm-up routines, stretching, and footwear choices should be incorporated to reduce the risk of recurrence.

• Gradual Return to Activity: When resuming physical activity, it’s essential to do so gradually, ensuring that the child avoids overexertion.

• Footwear Assessment: Regularly checking the fit and quality of shoes can help prevent future occurrences of Sever's Disease.

Conclusion

Sever's Disease, though painful, is a self-limiting condition that can be effectively managed through rest, appropriate footwear, and physical therapy. With a combination of lifestyle modifications, proper care, and regular monitoring, children can recover from Sever's Disease and continue to enjoy their favorite activities. If your child is experiencing persistent heel pain, consult a healthcare professional for proper diagnosis and treatment.

Disclaimer:

The information on this website is provided for educational and informational purposes only and is not medical advice. Always consult with a licensed medical provider and follow their recommendations regardless of what you read on this website. If you think you are having a medical emergency, dial 911 or go to the nearest emergency room. Links to other third-party websites are provided for your convenience only. If you decide to access any of the third-party websites, you do so entirely at your own risk and subject to the terms of use for those websites.

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!