Updated: Oct 31
Sever’s disease (or the official name, calcaneal apophysitis) is a condition which can affect children between the ages of 8 to 14 years old. Sever’s disease presents as pain in the heel, often during and after sports, which can range from mild discomfort to severe pain. Despite sounding scary, Sever’s disease is quite easily managed to ensure your child can continue with the sports they love.
What Is Sever’s Disease?
The root cause of Sever’s disease is inflammation of the growth plate in the calcaneus (the heel bone). This inflammation occurs due to the traction of the Achilles’ tendon on the calcaneus. Imagine the tendon tugging at the bone, essentially pulling it apart right at the growth plate. This traction increases significantly as the level of physical activity increases and is why the majority of children report pain during and after participating in sport.
Factors Exacerbating the Condition
Certain factors can amplify the risk and intensity of Sever's disease:
Calf Muscle Tightness: As your child grows, the growth of bones tends to outpace the growth of muscles and connective tissues. This leads to tightness in the calf muscle which in turn increases the traction on the heel bone, and consequently, the pain.
Flat Feet: The position of feet impacts the loads placed onto the Achilles tendon. A flat foot position can increase traction at the insertion of the Achilles onto the heel bone which can lead to increased pain.
High-Impact Sports: Young athletes engaged in high-impact sports like basketball, soccer, gymnastics, or even track events are more susceptible. The repetitive stress and impact on the heel in these activities can heighten the risk of developing this condition.
Prevalence Among Young Athletes
Sever’s disease is by far the most common cause of heel pain in children. While any developing child can experience Sever’s disease, it is especially prevalent among young athletes. The trend towards competitive sports from a young age and rigorous training routines make children increasingly more prone to the development of Sever’s disease. Awareness about Sever's disease, its symptoms, and preventive measures can play a pivotal role in ensuring our young athletes remain on top of their game.
How To Treat Sever’s Disease
The good news is that Sever’s disease will not cause lasting damage to your child. The bad news is that it can be very painful until the heel bone growth plate fuses without proper intervention. At My Family Podiatry, we treat Sever’s disease using a combination of:
Custom foot orthotics: Orthotics will often be used to deload the tissues through the foot. This can include a heel raise and arch support to decrease the tension placed on the Achilles’ tendon.
Shockwave Therapy: Shockwave therapy can be used to reduce the pain your child is suffering in their heels. This technique is non-invasive and is applied to the heel and Achilles tendon.
Massage: Using massage techniques, we can work to decrease tension in the calf muscles to reduce the force on the heel.
Ice and anti-inflammatories: Applying ice to the heel after exercise can help in easing some of the pain your child may be experiencing. Oral anti-inflammatories such as ibuprofen can be beneficial in easing some of the pain though always speak to a GP before taking any oral medications.
Once pain levels have reduced, we would work to increase the range of the calf muscles through a stretching and strengthening regime.
Tips To Prevent Sever’s Disease
Supportive Shoes: Ensure your child wears shoes that provide proper arch support, cushioning, and a snug fit. Avoid shoes that are too tight or lack support, especially during sports.
Sport-Specific Footwear: If your child is involved in a particular sport, invest in shoes designed specifically for that activity. For example, soccer cleats for soccer or basketball shoes for basketball. These are tailored to protect the feet against the common strains of the sport. If required, a heel raise can be added to these shoes to reduce load on the calf muscle and reduce the likelihood of developing Sever’s disease.
Daily Stretches: Encourage your child to stretch their calf muscles and Achilles tendon daily, especially before and after physical activities. Regular stretching can help maintain flexibility and reduce tension.
Warm-Ups: Before engaging in sports or intense physical activity, a proper warm-up session can prepare the muscles and tendons, reducing the risk of injuries.
If heel pain is affecting your child’s ability to enjoy sports and you are concerned it may be Sever’s disease, contact My Family Podiatry to discuss how we can help. Call 07 3088 6116 for more information or click the button below to book an appointment!