Sever?s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain In one or both feet. The disease is known to affect children between the ages of 8 and 14. Sever?s disease occurs when part of the child?s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes. Toe gait- develops in which the child must change the way they walk to avoid placing weight on the heel. This can lead to other problems as well in the future.
Sever disease is more common in children who do regular sports or exercise that puts pressure on the heels. Activities such as running and jumping can put stress on the tight muscles and tendons.
A few signs and symptoms point to Sever?s disease, which may affect one or both heels. These include Pain at the heel or around the Achilles tendon, Heel pain during physical exercise, especially activities that require running or jumping, Worsening of pain after exercise, A tender swelling or bulge on the heel that is sore to touch, Calf muscle stiffness first thing in the morning, Limping, A tendency to tiptoe.
Sever disease is most often diagnosed clinically, and radiographic evaluation is believed to be unnecessary by many physicians, but if a diagnosis of calcaneal apophysitis is made without obtaining radiographs, a lesion requiring more aggressive treatment could be missed. Foot radiographs are usually normal and the radiologic identification of calcaneal apophysitis without the absence of clinical information was not reliable.
Non Surgical Treatment
Occasionally, an orthotic may need to be prescribed for temporary or long-term correction of their foot biomechanics (eg flat feet or high arches). During the acute phase of Sever's disease a small heel rise or shock-absorbing heel cup placed under the heel pad of your child's foot may help to ease the symptoms. Your podiatrist or physiotherapist can assess your child's arch and guide you in the best management of your child's condition. We recommend that your child should never go barefooted during the painful stages of Sever's disease.
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.