Sever’s disease: what we can do about heel pain in children
Sever’s disease, also known as calcaneus apophysitis, is a common condition affecting the heel. It’s primarily seen in children aged 8 to 14 who are going through a growth spurt, as well as in children who are very active in sports. This condition affects the growth of bone and cartilage in the joints, leading to pain and limited movement.
Causes of Sever’s disease
Sever’s disease occurs when inflammation develops in the growth plate of the heel, known as the “calcaneal apophysis”. This is the area where new bone forms in growing children. While this apophysis is made of bone in adults, it is still cartilage in children. Repeated stress or pressure on this area can lead to inflammation. The condition is often associated with activities that place repetitive stress and pressure on the heel, which is why active children who participate in sports that involve a lot of running, jumping, or other heel-straining activities are at higher risk for developing Sever’s disease.
Symptoms of Sever’s disease
The most prominent symptom of Sever’s disease is heel pain, which can occur in one or both heels. The pain often worsens with physical activity and subsides with rest. Sever’s disease can also cause tenderness and swelling in the ankle, and difficulty walking on the affected foot. These symptoms often start after a period of rest following sports activities, or in the morning when getting out of bed. As the condition progresses, the pain may begin to appear during the activity itself.
Diagnosing Sever’s disease
A podiatrist can typically diagnose Sever’s disease based on the description of symptoms and a physical examination. One common test used in diagnosis is the “squeeze test”, where the sides of the heel are pressed together to identify the source of the pain. X-rays are usually not necessary for diagnosis, but they may be used to rule out other conditions if there is any doubt.
Treating Sever’s disease
Sever’s disease is a self-limiting condition, meaning it will resolve on its own once the heel has fully matured. In most cases, it takes about six months to a year for the growth spurt to end. The primary treatment for Sever’s disease involves reducing activity and incorporating periods of rest, which can be challenging for active children. There are also several other steps you can take to alleviate symptoms:
Pain relief: Apply ice to the heel to help reduce pain and inflammation.
Tension relief: Stretching exercises for the Achilles tendon and calf muscles can help relieve tension on the heel.
Pressure reduction: Wear sturdy, cushioned shoes or use heel pads. Even better, use shoes with corrective insoles and heel cushioning to provide extra relief by reducing the pulling tension and pressure on the heel.
To make this period as pain-free as possible, it’s always a good idea to consult with a podiatrist. Together, we can find the best exercises to help your child and, if necessary, fit custom orthotics to relieve pressure on the heel.