What Is Sever’s Disease?
Sever’s Disease, also known as calcaneal apophysitis, is a condition in which the growth plate of the heel bone is inflamed. In these cases, the majority of the heel bone is present at birth. Later in life, typically around eight years of age, a secondary growth center develops. By around age 14, the growth plate typically begins to form in a standard way and symptoms subside. For this reason, the condition is most common amongst children ages 8 to 14.
This new piece of bone is crescent-shaped and connected to the remainder of the heel bone by a layer of cartilage called the apophysis, also known as the growth plate. The Achilles tendon and the secondary piece of bone interfere with one another because movement of the tendon irritates the growth plate.
In children who are active in sports and physical activities, the growth plate can become inflamed and cause heel pain. While the growth plate is open, the severity of the pain will fluctuate. While activities like running and sports may cause pain, it does not harm or damage the growth plate.
Symptoms of Sever’s Disease
The most common symptom is pain that is localized to the back or at the bottom of the heel. This differs from adults with plantar fasciitis, who experience pain at the bottom of the foot or at the arch near the heel. The skin typically appears normal, but patients occasionally experience redness and swelling associated with it. As the inflammation and pain progress, the child may start to limp and eventually not want to participate in anything that involves excessive walking or running.
Treatment for Sever’s Disease
Our podiatrists at Performance Foot & Ankle in Camarillo will look at the symptoms of each individual case of Sever’s Disease and create a treatment plan to best address them. Some of the treatments our skilled and caring podiatrists might recommend include:
- Daily Achilles stretches and exercises. Because a tight Achilles will make symptoms worse, it is important to stretch this area daily when suffering from this condition. Stretches can be as simple as pressing the toes against the wall so the foot is in an upward position, or can involve towel scrunches that create mobility in the foot. Heel lifts in a stable running shoe are another helpful strengthening exercise. Our podiatrist will create a stretching plan specific to your child’s needs.
- Orthotics. Orthotics are custom-made heel inserts that will help provide heel support for patients who suffer from Sever’s Disease. They limit pronation, which decreases torque on the Achilles and decreases painful pull of the growth plate.
- Icing. Because Sever’s Disease is an inflammatory condition by nature, we often recommend icing the heel for 20 minutes daily, especially after sports or an extended period of physical activity. Oral or topical anti-inflammatories can also be helpful. This will help to reduce the tissue temperature and decrease secondary damage in surrounding tissue. Biofreeze, Arnica or Traumeel are types of topical anti-inflammatories that are especially helpful for children who cannot swallow pills.
- Immobilization. For more severe cases that result in limping, a fracture boot or cast might be necessary for two to four weeks. The patient should also avoid walking barefoot and opt for a running shoe that will alleviate pressure on the Achilles by directing it to the ball of the foot. Avoiding flip-flops and other unsupportive shoes is also recommended.
Not all cases of heel pain in children are caused by Sever’s Disease. If your child is experiencing heel pain, it is important to discover the cause. Call Performance Foot & Ankle in Camarillo today at (805) 380-3152 or contact us online so our podiatrists can help.