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Sever’s disease is a type of heel pain, also known as calcaneal apophysitis or calcaneo apophysitis. An apophysis is the ossific nucleus of a growth plate which is the site of insertion of ligaments and tendons. This area contains the open growth plate called physis. The closure of the calcaneus growth plate typically occurs around the age of 14. Until that time, new bone is forming at the calcaneal physis. In the foot, the posterior aspect of the calcaneum is the site of insertion of the Achilles tendon superiorly and the plantar fascia inferiorly. The pull of these two structures can put a significant strain on the apophysis, leading to pain and inflammation over the heel bone itself.
Risk Factors
- Kids in their growth spurt (usually 9–14 years old)
- Active in sports or activities that involve a lot of running or jumping, especially on hard surfaces (such as basketball, gymnastics, and track)
- High physical and sporting activities especially those involving repetitive running and jumping.
- Heel cord tightness
- Weak ankle dorsiflexion
- Poorly cushioned or worn-out athletic shoes.
- Biomechanical factors such as genu varum, and pes planus
- Greater waist circumference and increased height.
Symptoms of Sever's Disease
- Swelling and redness in the heel
- Stiffness in the feet when first waking up.
- Limping, or walking on tiptoes.
- Pain when the heel is squeezed on both sides.
Management of Sever's Disease
- Use an elastic wrap or compression stocking to help with pain and swelling.
- Heel pads. Heel cushions inserted in sports shoes can help absorb impact and relieve stress on the heel and ankle.
- Physical therapy, or a home exercise program given to you by the health care provider to help with stretching and strengthening.
- Gentle mobilizations to the subtalar joint and forefoot area.
- Taping the foot around the arch and heel area has been noted to reduce pain.
- Wearing shoes with a slightly elevated heel. Elevating the heel may relieve some of the pressure on the growth plate.