Overview
Sever's Disease, also known as calcaneal apophysitis, is a disease of the growth plate of the bone and is characterized by pain in the heel of a child's foot, typically brought on by some form of injury or trauma. This condition is most common in children ages 10 to 15 and is frequently seen in active soccer, football, or baseball players. Sport shoes with cleats are also known to aggravate the condition. The disease mimics Achilles tendonitis, an inflammation of the tendon attached to the back of the heel. A tight Achilles tendon contributes to Sever's Disease by pulling excessively on the growth plate of the heel bone (calcaneus). Treatment includes cutting back on sports activities, calf muscle stretching exercises, heel cushions in the shoes, icing, and/or anti-inflammatory medications. Note: Please consult your physician before taking any medications.
Causes
With early puberty, the growth plate at the end of the heel develops, transforming cartilage cells into bone cells. This painful heel condition occurs during these growth spurts, when the heel bone grows more rapidly than the muscles and tendons of the leg. The discrepancy between rates of development causes excess pressure and tension to be placed upon the heel and it becomes less flexible. This condition affects active children the most. Due to the amount of exercise, more stress is placed upon the tendons which in turn causes more damage to the growth plate. The bone plates fully mature and harden by the time a child reaches the age of 15.
Symptoms
Acute pain, pain asscoiatied with Sever?s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running. Highly active - children who are very active are among the most susceptible in experiencing Sever?s disease, because of the stress and tension placed on their feet.
Diagnosis
Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.
Non Surgical Treatment
* Cold packs: Apply ice or cold packs to the back of the heels for around 15 minutes after any physical activity, including walking.
* Shoe inserts: Small heel inserts worn inside the shoes can take some of the traction pressure off the Achilles tendons. This will only be required in the short term.
* Medication: Pain-relieving medication may help in extreme cases, but should always be combined with other treatment and following consultation with your doctor).
* Anti-inflammatory creams: Also an effective management tool.
* Splinting or casting: In severe cases, it may be necessary to immobilise the lower leg using a splint or cast, but this is rare.
* Time: Generally the pain will ease in one to two weeks, although there may be flare-ups from time to time.
* Correction of any biomechanical issues: A physiotherapist can identify and discuss any biomechanical issues that may cause or worsen the condition.
* Education: Education on how to self-manage the symptoms and flare-ups of Sever?s disease is an essential part of the treatment.
Recovery
It may take several weeks or months for the pain to completely stop. When the pain is completely gone, your child may slowly return to his or her previous level of activity.
Sever's Disease, also known as calcaneal apophysitis, is a disease of the growth plate of the bone and is characterized by pain in the heel of a child's foot, typically brought on by some form of injury or trauma. This condition is most common in children ages 10 to 15 and is frequently seen in active soccer, football, or baseball players. Sport shoes with cleats are also known to aggravate the condition. The disease mimics Achilles tendonitis, an inflammation of the tendon attached to the back of the heel. A tight Achilles tendon contributes to Sever's Disease by pulling excessively on the growth plate of the heel bone (calcaneus). Treatment includes cutting back on sports activities, calf muscle stretching exercises, heel cushions in the shoes, icing, and/or anti-inflammatory medications. Note: Please consult your physician before taking any medications.
Causes
With early puberty, the growth plate at the end of the heel develops, transforming cartilage cells into bone cells. This painful heel condition occurs during these growth spurts, when the heel bone grows more rapidly than the muscles and tendons of the leg. The discrepancy between rates of development causes excess pressure and tension to be placed upon the heel and it becomes less flexible. This condition affects active children the most. Due to the amount of exercise, more stress is placed upon the tendons which in turn causes more damage to the growth plate. The bone plates fully mature and harden by the time a child reaches the age of 15.
Symptoms
Acute pain, pain asscoiatied with Sever?s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running. Highly active - children who are very active are among the most susceptible in experiencing Sever?s disease, because of the stress and tension placed on their feet.
Diagnosis
Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.
Non Surgical Treatment
* Cold packs: Apply ice or cold packs to the back of the heels for around 15 minutes after any physical activity, including walking.
* Shoe inserts: Small heel inserts worn inside the shoes can take some of the traction pressure off the Achilles tendons. This will only be required in the short term.
* Medication: Pain-relieving medication may help in extreme cases, but should always be combined with other treatment and following consultation with your doctor).
* Anti-inflammatory creams: Also an effective management tool.
* Splinting or casting: In severe cases, it may be necessary to immobilise the lower leg using a splint or cast, but this is rare.
* Time: Generally the pain will ease in one to two weeks, although there may be flare-ups from time to time.
* Correction of any biomechanical issues: A physiotherapist can identify and discuss any biomechanical issues that may cause or worsen the condition.
* Education: Education on how to self-manage the symptoms and flare-ups of Sever?s disease is an essential part of the treatment.
Recovery
It may take several weeks or months for the pain to completely stop. When the pain is completely gone, your child may slowly return to his or her previous level of activity.