Sever disease refers to a calcaneal apophysitis (an inflammation of the apophysis of the heel) which occurs in children and young adolescents. It typically presents in active young children
(especially ones who engage in jumping and running sports).
Young athletes typically sustain the injury due to repeated stress caused by running and jumping. Partaking in any high speed sports can thus partly provoke the condition, such as football, rugby,
basketball, hockey or track athletics. Crucially the injury is linked to overuse, so exercising with fatigued leg muscles, without a suitable warm up, or beginning a new strenuous physical activity
are all risk factors. Placing excessive weight or pressure on the heel can also cause the injury. Another factor related to Sever's disease is overpronation, a biomechanical error that makes the foot
roll too far inwards.
The main symptom of sever's disease is pain and tenderness at the back of the heel which is made worse with physical activity. Tenderness will be felt especially if you press in or give the back of
the heel a squeeze from the sides. There may be a lump over the painful area. Another sign is tight calf muscles resulting with reduced range of motion at the ankle. Pain may go away after a period
of rest from sporting activities only to return when the young person goes back to training.
In Sever's disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or
she runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that
your child's heel tendons have become tight.
Non Surgical Treatment
The disease can be treated easily and is considered to be temporary, if treated promptly and correctly. If left untreated or if treated improperly, the disease can result in a permanent heel
deformity, causing future shoe-fitting difficulties. Other long-term effects can include foot arch problems, potentially resulting in plantar fasciitis or heel spurs and tight calf musculature, which
can lead to Achilles tendonitis. The American College of Foot and Ankle Surgeons recommends the following steps, once Sever?s disease has been diagnosed. Reduce or stop any activity that causes pain.
Temporary shoe inserts or custom orthotic devices may provide support for the heel. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help reduce the pain and inflammation.
Stretching and/or physical therapy may be used to promote healing. In severe cases, a cast may be used to keep the foot and ankle immobilized during the healing process.
The best way to prevent Sever's disease is to make sure that your child wears shoes that fit properly. The heel portion of the shoe should not be too tight, and there should be good padding in the
heel. It may help to put extra heel pads in your child's shoes. Some children simply get too much physical activity. For example, they may play on too many teams or practice for too long. Their heel
pain is a message to slow down.