Sever's disease is a common cause of heel pain in adolescence. Developing, physically active ?kids? are more prone to Sever's. During puberty the calcaneus consist of two developing sites of bone
known as ossification centres. These two areas are seperated by an area of cartilage known as the calcaneal apophysis. The Achilles tendon attaches the triceps surae (calf muscles) to the calcaneus
(heel bone). As a child grows the calcaneus grows faster than the surrounding soft tissue, which means the Achilles tendon is pulled uncomfortably tight. This increase in strain causes inflammation
and irritation of the calcaneal apophysis (growth plate) which is known as Sever's Disease. The pain is exacerbated by physical activities, especially ones involving running or jumping. Sever's
disease most commonly affects boys aged 12 to 14 years and girls aged 10 to 12 years, which corresponds with the early growth spurts of puberty.
The condition generally occurs in active children at early adolescence during rapid growth periods as the heel bone can grow faster than the leg muscles causing them to become tight and
overstretched. Sever?s disease most often caused by inadequate footwear, playing sport on hard surfaces, calf tightness and biomechanical problems.
As a parent, you may notice your child limping while walking or running awkwardly. If you ask them to rise onto their tip toes, their heel pain usually increases. Heel pain can be felt in one or both
heels in Sever's disease.
A doctor can usually tell that a child has Sever's disease based on the symptoms reported. To confirm the diagnosis, the doctor will probably examine the heels and ask about the child's activity
level and participation in sports. The doctor might also use the squeeze test, squeezing the back part of the heel from both sides at the same time to see if doing so causes pain. The doctor might
also ask the child to stand on tiptoes to see if that position causes pain. Although imaging tests such as X-rays generally are not that helpful in diagnosing Sever's disease, some doctors order them
to rule out other problems, such as fractures. Sever's disease cannot be seen on an X-ray.
Non Surgical Treatment
First, your child should cut down or stop any activity that causes heel pain. Apply ice to the injured heel for 20 minutes 3 times a day. If your child has a high arch, flat feet or bowed legs, your
doctor may recommend orthotics, arch supports or heel cups. Your child should never go barefoot. If your child has severe heel pain, medicines such as acetaminophen (one brand name: Tylenol) or
ibuprofen (some brand names. Advil, Motrin, Nuprin) may help.
Perform a well rounded dynamic warm up before activity. Perform a good static stretching routine after activity. Increase core strength. Perform exercises that emphasize active lengthening of the
calf muscles. Use proper footwear. Avoid excessive running or jumping on hard surfaces like concrete by using better surfaces such as asphalt, gymnasium floors or grass.