About the condition
Sever's Disease (Calcaneal Apophysitis)
What is Sever's Disease? Sever's disease, also known as calcaneal
apophysitis, is a common cause of heel pain in growing children and
adolescents. It occurs when the growth plate in the heel becomes
inflamed due to repetitive stress or overuse. It is usually seen very
athletic teenagers during growth phases. This is often misdiagnosed as
Plantar fasciitis which is very uncommon in children.
Symptoms
• Pain and tenderness in the heel, especially during physical
activities.
• Swelling and redness in the heel.
• Difficulty walking or running.
• Stiffness in the foot, particularly in the morning.
Causes
• Overuse or repetitive stress on the heel.
• Participation in sports that involve running or jumping.
• Wearing improper footwear.
• Biomechanic predisposition.
• Tight calf muscles.
• Above average athleticism for age group.
Diagnosis A podiatrist will diagnose Sever's disease based on your
child's medical history and a physical examination of the foot. Imaging
tests such as X-rays may be used to rule out other conditions.
Treatment
• Relative Rest: Rule of 50% reduction of sports participation per
week for 3weeks, if no improvement a further 50% reduction for
a further 3 weeks.
• Footwear: Ensure your child wears supportive trainers with a
positive heel stack for all weightbearing activity.
• Heel raises: in shoe heel raises to be used when trainers
cannot be worn.
• Orthotics: Use custom orthotic devices to support the feet.
• Medication: Analgesic use if needed rather than anti
inflammatories (NSAIDs) which can slow bone healing.
• Stretching: once symptoms become manageable, perform
exercises to stretch the calf muscles and Achilles tendon.
• Physical Therapy: A physiotherapist can provide exercises and
treatments to help build strength and tissue capacity.
• Fracture boot/total contact casting: in extreme cases under
orthopaedic guidance.
Prevention
• Ensure your child wears supportive footwear.
• Stretch the feet and calves regularly, especially during growth
phases.
• Gradually increase the intensity of physical activities.
