Sever’s Disease

Sever’s Disease - Definition, Causes, Symptoms, & Treatment

What is Sever's Disease?

Sever’s disease, also known as calcaneal apophysitis, is basically what happens when the heel’s growth plate has a painful inflammation. This usually results from a dramatic growth spurt, in which the heel bone grows at a faster rate than the muscles and tendons surrounding it. Because of this, said muscles and tendons may become overstretched and tight, which in turn makes the heel less flexible and puts pressure on the growth plate. The Achilles tendon is attached to the heel’s growth plate. This swelling occurs over time because the tight Achilles tendon causes damage to the growth plate from repeated stress and Sever’s disease results. Girls may see their growth spurts between eight and thirteen, and boys between ten and fifteen.

Sever's disease diagram

Regardless of how menacing the name sounds, Sever’s disease is a common enough affliction of the heel that happens to many kids. While it is painful, is usually temporary and will not harm your child in a long-term. Yet you will want to treat it as soon as possible for your child’s overall well-being

Sever's Disease - What Every Parent Should Know

Video #1 - The Diagnosis

In this video, Dr. Mikkel Jarman discusses the diagnosis of Sever’s Disease, otherwise known as calcaneal apophysitis, and how to diagnosis it.

Video #2 - The Treatment

In this video, Dr. Mikkel Jarman discusses the treatment of Sever’s Disease, and the difference between acute and chronic conditions.

Causes of Sever’s Disease

The following conditions may increase your child’s chances of contracting Sever’s disease.

  • A pronated foot, or a foot that rolls at the ankle when walking. This may cause a twisting and tightness of the Achilles tendon, which increases the pull on the heel’s growth plate.
  • High or flat arches, which can affect the heel’s angle within the foot.
  • Being overweight or suffering from obesity, which may put additional pressure on the growth plate.
  • Short leg syndrome. This is when one leg is shorter than the other one. Thus forcing the shorter leg to bend down in order to reach the ground.

Adults and children suffer from heel pain differently. Pediatric heel pain will not get better from walking and will aggravate it more, as does standing too long, which puts additional pressure on the heel.

Symptoms of Sever's Disease

Tenderness or pain in either one or both heels is the most obvious sign of Sever’s disease. This usually occurs in the back. However, it is possible for the pain to also go down the sides and the bottom of the heel, right around the arch of the foot.

Other symptoms and problems of Sever's Disease may include:

  • Difficulty with walking
  • Discomfort if the heel is squeezed on both sides
  • Redness or swelling of the heel
  • When walking, the feet are stiff or discomforted
  • Walking unusually, to avoid putting pressure on the heel by walking on one’s tiptoes or with a limp.

Treating Sever's Disease

The primary concern of treating this disease is to relieve the pain. Since activity tends to make the symptoms worse, the main treatment is to rest. This will relieve the pressure on the heel bone, and decrease the swelling while reducing pain.

The doctor will usually direct the child to cut back on all activities and sports until the swelling goes down and the pain is gone. Running barefoot or upon hard surfaces are usually the worst offenders, since they impact the feet and can worsen inflammation and pain. If a child wants to remain active, he or she could try biking or swimming since these do not put pressure on the heel. However, you should go over it with the doctor first.

Children's Feet Treatment Dr. Mikkel Jarman

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Doctor may recommend the following for Children with Sever’s disease:

  • Do leg and foot exercises that focus on strengthening and stretching leg tendons and muscles.
  • Use a compression stocking – to decrease swelling and pain.
  • Elevate the leg and apply ice (not directly to the skin). Do this for twenty minutes up to three times a day. It should be done even on days when the pain is not bad. This will help reduce the swelling.
  • Ingest over-the-counter medications that focus on reducing swelling and pain. These include acetaminophen like Tylenol or ibuprofen like Advil and Motrin, not aspirin.
  • Overweight or Obese Children – the odds are good that the doctor will recommend a weight loss regimen in order to decrease the pressure on the heel.
  • If your child has a severe case of Sever’s disease, the doctor may want him or her to wear a cast between 2 to 12 weeks. This will immobilize the foot so it has a better chance of healing.

Proper Shoes for Pediatric Heel Pain

is important that the child wear proper shoes find a parent that are good quality, shock absorbent, and are well fitted to help reduce the pressure. In more extreme cases, it may be a good idea to get open back shoes, as they do not rub on the heel. Avoid high heels and heavy shoes. After any and all activities, stretching exercises should be done and the affected heel should be iced.

Shoe Inserts and Orthotic Devices

A child with a pronated foot, high or flat arches, or other such conditions might receive a recommendation from the podiatrist for orthotic devices:

  • Heel lifts that raise the heel and reduce the strain on the Achilles tendon.
  • Arch supports made to keep the heel in a good position.
  • Heel pads that protect and cushion the heel every time it strikes the ground.
Shoes that do not fit well are another contributing factor to the condition. They do not provide enough padding or support, and may rub against the heel. If a child is involved with activities that include running and jumping on hard surfaces, then they may be at risk as well. Common activities include basketball, gymnastics, soccer, and track.

Pediatric Heel Pain

If a child is suffering from pediatric heel pain that affects both the bottom and back of the heel, then they may have a condition called (Sever’s Disease). This pain flares up every time the child does any activity on his or her feet. This means that they are affected whenever they are playing, walking, or even standing. A podiatrist may suggest foot exercises, bed rest, or orthotic devices to help relieve the pain. It is possible for Sever’s disease to heal quickly, but it can recur over the long term if there are no measures taken to protect the child’s heels, especially between the ages 8 to 15, the growing years.

Your child’s feet are designed for life

Make an appointment today if your child has heel pain.
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