Sever's disease is a disorder that commonly occurs in active children between the ages of 9 and 13 years of age. Even though it is misnamed as a disease, it is actually a self-limiting disorder that
occurs around the growth plate in the back of the heel. The Achilles tendon attaches to the upper portion of the heel growth plate. On the bottom of the growth plate is an attachment of a ligament
known as the plantar fascia. With increased activity, there is a pulling or tugging that occurs on this growth plate, and a portion of the growth plate is being pulled away from its attachment to the
heel. X-rays are often taken to verify the position and location of this growth plate.
Apart from the age of the young person, other factors that may contribute to developing the disease may include; overuse or too much physical activity. Your child?s heel pain may be caused by
repeated stress on the heels (running and jumping activities), pressure on the back of the heel from too much standing or wearing poor-fitting shoes. This includes shoes that do not support or
provide enough padding for your child?s feet.
The most prominent symptom of Sever's disease is heel pain which is usually aggravated by physical activity such as walking, running or jumping. The pain is localized to the posterior and plantar
side of the heel over the calcaneal apophysis. Sometimes, the pain may be so severe that it may cause limping and interfere with physical performance in sports. External appearance of the heel is
almost always normal, and signs of local disease such as edema, erythema (redness) is absent. The main diagnostic tool is pain on medial- lateral compression of the calcaneus in the area of growth
plate, so called squeeze test. Foot radiographs are usually normal. Therefore the diagnosis of Sever's disease is primarily clinical.
Sever's disease is diagnosed based on a doctor?s physical examination of the lower leg, ankle, and foot. If the diagnosis is in question, the doctor may order X-rays or an MRI to determine if there
are other injuries that may be causing the heel pain.
Non Surgical Treatment
Treatment aim is to lessen the load on the insertion of the Achilles tendon, along with pain relief if necessary. This can be achieved by modifying/reducing activity levels. Shoe inserts or heel
raises. Calf stretches. Avoiding barefoot walking. Strapping or taping the foot to reduce movement. Orthotic therapy if due to biomechanical causes. Other treatment includes icing of the painful area
to reduce swelling, pain medication if necessary and immobilisation of the affected limb in severe or long standing cases.
Sever?s disease is self-recovering, meaning that it will go away on its own when the foot is used less or when the bone is through growing. The condition is not expected to create any long-term
disability, and expected to subside in 2-8 weeks. The disease may also take several years to stop, because it is often triggered by growing too fast. It is more common in boys, although occurs in
girls as well. The average age of symptom onset is 9-11.