Sever’s disease (calcaneal apophysitis) is the most common cause of heel pain in children, particularly in physically active adolescents who are about to begin puberty. Sever’s disease is a painful inflammation of the heel’s growth plate, which is located in the lower back of the heel, where the Achilles tendon (the heel cord that attaches to the growth plate) attaches. It typically affects children between the ages of 8 and 14 years old during periods of rapid growth, because the heel bone (calcaneus) is not fully developed until approximately 15. Until then, the repetitive stress of physical activity can irritate the growth plate resulting in pain.
Causes of Sever’s disease
Overuse and stress to the heel is the primary cause of Sever’s disease. The heel’s growth plate remains weak and sensitive until it is fully formed, and the repetitive stresses of sport and activities that involve a lot of heel movement can cause irritation to the growth plate. Children going through periods of rapid growth are more at risk due to the heel bone growing faster than the attaching muscles. The results in the Achilles tendon being pulled very tightly on the growth plate, causing pain and inflammation.Risk factors include:
Sports that involve running and jumping on hard surfaces (basketball, netball athletics)
Standing for long periods, which places constant pressure on the achilles tendon
Flat feet (over pronated)
Symptoms of Sever’s disease
Symptoms of Sever’s disease include:
Pain, swelling and redness in the back or bottom of the heel
Walking on toes
Difficulty running, jumping, or participating in usual activities or sports
Pain when the sides of the heel are squeezed
Treatment of Sever’s disease
It is important a podiatric assessment be performed to rule out other more serious conditions. It is also recommended that early treatment takes place as symptoms can quickly progress without the appropriate steps being taken. At OnePoint Podiatry a Biomechanical Assessment is performed. During the assessment our podiatrists will obtain a thorough medical history and asks questions about recent activities. Examination for the the child’s foot and leg will also take place, along with assessment of any potential causative or risk factors. X-rays are also often used to evaluate the condition. Assessment findings are then used to develop a treatment plan specific to the child. Some treatment options may include:
Rest. Avoid activity that cause irritation and stress to the heel.
Ice. To ease pain and swelling. Do this for 20-30 minutes every 3 to 4 hours for 2 to 3 days, or until the pain is gone. At OnePointHealth we also provide Game Ready Ice Compression system.
Compression. compression bandages help to reduce swelling.
Elevation. Raising the foot above the level of the heart helps to reduce swelling.
Physical therapies. Rehabilitation programs help to promote healing and range of motion.
Anti-inflammatory. Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, naproxen, or aspirin, will help with pain and swelling.
Immobilisation. In some severe cases of heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile.
Adequate footwear. Supportive footwear may also be recommended to stabilise the foot and ankle to reduce stress on the heel bone.
Taping/Bracing. Taping or bracing can help to stabilise the foot and ankle and reduce excessive stress on the Achilles tendon and heel bone.
Orthotic therapy: A custom orthotic device placed in the shoe can help stabilise the foot and address possible causative factors such as flat feet.
Your health. In the right direction.
Our purpose is to make your health number one! Our integrated team approach allows us to guide your health in the right direction, taking away your worry of whom to see and where to find them. OnePointHealth, all your health needs, under one roof.
It is not normal for children to experience foot or lower limb pain, and there is no such thing as “growing pains.” Any pain that lasts more than a few days, or that is severe enough to limit the child’s walking, should be assessed by a podiatrist straight away. Many foot or lower limb problems during adulthood stem from untreated […]
Children spend around 30 hours a week in their school shoes, or more than 15,000 hours during their school years, so correctly fitted schools shoes are very important. Ill-fitting shoes can lead to problems in adulthood, such as ingrown toenails, corns and bunions, which may even require surgery later in life. Here are some tips […]
There is a common misconception that heel spurs are the cause of pain, but in fact, many people live day to day with spurs and have no symptoms relating to them. Generally, both the pain and the growth of the spur are related to irritation of the plantar fascia. For most patients, plantar fasciopathy is […]
What are ingrown toenails (Onychocryptosis)? When a toenail is ingrown, it is curved and grows into the surrounding skin as the nail grows. Ingrown toenails irritates the skin, often creating pain, redness, swelling, and warmth in the toe. If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is […]
Intoeing is when the feet turn inwards during gait and is commonly known as being pigeon-toed. This is often seen among children and in most cases will resolve without treatment as the child grows. This is why it’s less commonly seen in adults. Intoeing may initially cause a child to trip but should reduce over […]
OnePointHealth remains OPEN. Our top priority is maintaining the health and safety of our patients and staff. For these reasons, we have further increased our existing strict protocols to ensure we are adhering to the guidelines delivered by NSW Health.