Sever’s disease is the more commonly known name for calcaneal apophysitis and is a common cause of heel pain in younger more active children. Children between the ages of 8-14 experience rapid growth of the heel bone (calcaneus) and this area can become irritated and painful. Typically, it affects boys more than girls and can coincide with other common foot conditions such as plantar fasciitis.
What are the symptoms?
Typically, the pain occurs during or immediately after activity and is localized to the back of the heel but also can radiate to the whole heel and some of the arch. Children may not necessarily tell you that they are in pain especially if its during or after an activity or sport they really love doing. One thing to look out for is limping whilst the activity is occurring or immediately after, along with obvious signs of complaints of pain or discomfort.
What causes it?
Calcaneal apophysitis is the inflammation of the growth plate in the heel and typically coincides with a recent growth spurt or increase in shoe size. A growth spurt causes the bones in the legs to increase in length leaving the muscles that attach onto these bones tight and taught. Combining these tight muscles with high amounts of activity or a recent increase in activity causes the inflammation of the heel bone at its growth plate.
How common is it?
Calcaneal apophysitis is extremely common and typically occurs in children between the ages of 8-14 but is seen clinically as young as 6 and as old as 16, it is somewhat dependent on the child’s development. Children with a higher BMI (Body Mass Index) or overweight children are also at an increased risk of developing this condition due to increased forces on the structures and tendons involved.
What is the treatment/recovery time?
The first line of treatment is rest and icing, which may prove difficult with a child that enjoys participating in a particular sport or activity. However in order for the inflammation and pain to be reduced rest and icing is required, especially in the initial phase of the condition’s development.
The second line of treatment is prefabricated or custom orthotics and heel raises which is usually very effective and often recommended for very active children who may not want to stop the activities that are contributing to the pain. Orthotics and reduction of the child’s BMI (losing weight) will help with longer term prevention of the Sever’s disease. With the use of orthotics most cases can resolve in a few weeks to approximately 2 months however every child is different.
If left untreated Sever’s Disease can progress to necrosis of the growth plate or fractures of the heel bone (calcaneus) which can potentially need further more drastic intervention. It is always best to see a podiatrist to assess the severity and determine the best treatment. Our Podiatrists see this condition on a regular basis and are experts in the management of Sever’s Disease
