Sever’s disease involves a lesion to the heel that appears mostly as a result of excessively twisting the ankle. The injury is particularly prevalent in children over 10 and other younger athletes because the heel bone, muscles and tendons are still developing – the bone faster than the muscles – and the condition strikes a growing part of the bone called the calcaneal apophysis. In older people an injury of this sort generally results in a stress fracture.
Sever?s is often present at a time of rapid growth in adolescent athletic children. At this time the muscles and tendons become tighter as the bones become larger. Between 8 – 15 years of age is the usual onset of this condition.
Unilateral or bilateral heel pain. Heel pain during physical exercise, especially activities that require running or jumping. Increased pain level after exercise. A tender swelling or bulge on the heel that is painful on touch. Limping. Calf muscle stiffness first thing in the morning.
To diagnose the cause of the child?s heel pain and rule out other more serious conditions, the foot and ankle surgeon obtains a thorough medical history and asks questions about recent activities. The surgeon will also examine the child?s foot and leg. X-rays are often used to evaluate the condition. Other advanced imaging studies and laboratory tests may also be ordered.
Non Surgical Treatment
If your child have Sever’s disease, the following is suggested, cut back on sporting activities, don’t stop, just reduce the amount until symptoms improve (if the condition has been present for a while, a total break from sport may be needed later) avoid going barefoot, a soft cushioning heel raise is really important (this reduces the pull from the calf muscles on the growth plate and increases the shock absorption, so the growth plate is not knocked around as much). Stretch the calf muscles, provided the stretch does not cause pain in the area of the growth plate). The use of an ice pack after activity for 20mins is often useful for calcaneal apophysitis – this should be repeated 2 to 3 times a day.
Sever’s Disease may be prevented by maintaining good flexibility while the child is growing. The stretching exercises can help lower the risk for injuries during a growth spurt. Having good quality shoes with firm support and a shock-absorbent sole will also help. Child should also avoid excessive running on hard surfaces.