Sever’s disease (or calcaneal apophysitis) is a common condition that can affect children and adolescents aged 8-15. It involves inflammation of the heel bone growth plate, in particular where the Achilles tendon attaches to the heel, the tough band of tissue that connects the calf muscle to the heel bone and can manifest during rapid growth spurts in the child and commonly coincides with increased activity levels.
The condition is commonly seen in active children who engage in sports that involve running and jumping, including basketball, soccer, track-running and gymnastics. The main symptom is heel pain and often is profound during activity and tends to improve during rest periods. Over time, pain may intensify, potentially leading to activity limitations.
Factors contributing to the likelihood of developing Sever’s disease include higher body mass index (BMI), increased or excessive sports engagement, restricted ankle mobility, poorly-cushioned or worn out sneakers or shoes, running on hard surfaces and suboptimal ankle alignment for example flat feet or high arches.
There are management techniques that can be used to improve symptoms and prognosis.
- Limiting participation in strenuous aggravating activities, including running and jumping until symptoms resolve.
- Pain relief such as paracetamol or anti-inflammatory medicines such as ibuprofen may be used for short periods of bad pain
- Supportive shoes
- Ice application
- Heel lifts, cups or pads can help reduce traction forces and alleviate pain
- Stretching and exercises
Sever’s disease is a self-limiting condition that resolves with time however there can be periods where symptoms recur until the child has finished their growth spurt and their growth plates have turned into solid bone. Once your child has finished their growth spurt the pain will likely cease and cause no long term issues.