Sever’s Disease is one of the most common causes of heel pain in active adolescents. Hip stability is restored using a non-surgical positioning device. Symptoms of Sever’s disease are relieved through a combination of conservative treatment options and preventative measures can be taken to decrease the risk of developing the condition.
One of the most common causes of heel pain in adolescents, Sever’s disease is an overuse injury to the growth plate of the calcaneus (heel). It is commonly seen in growing, active children 8-12 years of age. Soccer players, gymnasts, and children who do any sort of running or jumping activity have an increased risk of developing Sever’s disease. Occurring in one or both feet, Sever’s disease occurs at the back of the heel (also known as the apophysis or the insertion of the Achilles tendon). Pain symptoms usually begin after a child begins a new sport or sporting season, and can worsen with athletic activities that involve running and jumping. It is common for a child with Sever’s disease to walk with a limp.
Increased activity can lead to heel cord tightness (Achilles Tendon), resulting in pressure on the apophysis of the calcaneus. This will cause irritation of the growth plate and sometimes swelling in the heel area thus producing pain. This usually occurs in the early stages of puberty.
For patients suffering from Sever’s disease, the pediatric orthopaedic surgeon will often recommend a conservative treatment plan including:
There are rarely any complications with the treatment of Sever’s disease, and symptoms generally resolve within 2 weeks to 2 months. Patients can typically return to playing sports again after the heel pain has resolved. The physician will let confirm when it is safe to resume physical activities.
For children with Sever’s disease, it is important to habitually perform exercises to stretch the hamstrings, calf muscles, and the tendons on the back of the leg. Stretching should be performed 2-3 times a day. Each stretch should be performed for 20 seconds, and both legs should be stretched, even if the pain is only in one heel.
Heel cups or an inner shoe heel lifts are often recommended for patient suffering from Sever’s disease. Wearing running shoes with built in heel cups can also decrease the symptoms because they can help soften the impact on the heel when walking, running, or standing.
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.
Dr. Drew Warnick is a board-certified sports medicine specialist at Children’s Orthopaedic and Scoliosis Surgery Associates, renowned for their high quality care in the treatment of pediatric sports injuries. To learn more about Children’s Orthopaedic’s sports medicine specialties, schedule an appointment at one their four Tampa Area offices.
