Sever’s Disease

What is it ?

Sever’s disease, also known as calcaneal apophysitis, is a condition which can result in debilitating heel pain due to inflammation and irritation of the growth plate (apophysis) in the heel bone (calcaneus). It affects children and adolescents typically between the ages of 8 and 14, especially those who are very physically active.

Causes

• Sudden increase in the amount or intensity of sport or physical activity.

• Abnormal foot posture/biomechanics of feet (flat feet or a high arch)

• Unsupportive footwear

• Tight calf muscles

• New terrain: repetitive running and jumping on hard surfaces.

Signs and Symptoms

• Pain during or after sport in the back of the heel, instep and calf

• Limping or toe walk to try to alleviate their symptoms

Treatment

• Rest

• Activity modification: temporarily stop or reduce level of high impact of activities

• Apply a cold compress immediately after activity to alleviate initial inflammation. Transition to a heat pack later in the day or evening for pain relief.

• Exercise therapy: including strengthening and stretching exercises of calf muscles

• Offloading the tendon: over the counter or prescribed shoe inserts to address any biomechanical issues

• Load management - gradual return to activity once symptoms reduce or subside