Severs Disease The Facts

Overview

The true name of this complaint is calcaneal apophysitis which just means an inflamation of the growth centre of the bone in your heel as a result of pulling by the Achilles tendon – it is important to realise that it is not a disease but rather a condition that develops in the growing skeleton with activity. It is the most common cause of heel pain in young athletes, and is the second most common condition of its kind in the younger athelete after Osgood-Schlatter’s disease. It is often seen at a time of rapid growth during which the muscles and soft tissues become tighter as the bones get longer. It occurs more in boys than girls and is seen most commonly between the ages of 8 and 14 years though it tends to be more prevalent in the younger of this group.

Causes

Sever?s disease is directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves a lot of heel movement. It can be associated with starting a new sport, or the start of a new season. Children who are going through adolescence are also at risk of getting it because the heel bone grows quicker than the leg. Too much weight bearing on the heel can also cause it, as can excessive traction since the bones and tendons are still developing. It occurs more commonly in children who over-pronate, and involves both heels in more than half of patients.

Symptoms

The most common symptom of Sever’s disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are very active athletes are among the group most susceptible to experiencing Sever’s disease because of the extreme stress and tension they place on their growing feet. Improper pronation, the rolling movement of the foot during walking or running, and obesity are all additional conditions linked to causing Sever’s disease.

Diagnosis

Sever?s disease can be diagnosed based on your history and symptoms. Clinically, your physiotherapist will perform a “squeeze test” and some other tests to confirm the diagnosis. Some children suffer Sever?s disease even though they do less exercise than other. This indicates that it is not just training volume that is at play. Foot and leg biomechanics are a predisposing factor. The main factors thought to predispose a child to Sever?s disease include a decrease in ankle dorsiflexion, abnormal hind foot motion eg overpronation or supination, tight calf muscles, excessive weight-bearing activities eg running.

Non Surgical Treatment

It is important that those with Sever?s Disease are treated by a medical professional to reduce pain and allow children to continue to participate in sporting activities. The Athlete?s Foot recommends a visit to your local medical professional to be diagnosed correctly and receive specialised care. Symptoms include pain through the back of the heel where the Achilles tendon inserts into the heel bone, pain during activity especially running and jumping and the back of the heel may be tender to touch.

Prevention

Once your child?s growth spurt ends, and she’s reached full size, her Sever?s disease won?t return. Until then, the condition can happen again if your child stays very active. Some simple steps can help prevent it. Have your child. Wear supportive, shock-absorbing shoes. Stretch her calves, heels, and hamstrings. Not overdo it. Warn against over-training, and suggest plenty of rest, especially if she begins to feel pain in her heel. Try to avoid lots of running and pounding on hard surfaces. If she?s overweight, help her lose those extra pounds, which can increase pressure on her heels.

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