This condition is self limiting, it will go away when the two parts of bony growth join together, this is natural. Unfortunately, Sever's disease can be very painful and limit sport activity of the
child while waiting for it to go away, so treatment is often advised to help relieve it. In a few cases of Sever's disease, the treatment is not successful and these children will be restricted in
their activity levels until the two growth areas join, usually around the age of 16 years. There are no known long term complications associated with Sever's disease.
There are many biomechanical factors that predispose a young athlete to calcaneal apophysitis. The majority of patients will present with an ankle equinus deformity, which ultimately exerts an
increased pulling force to the Achilles insertion and non-ossified apophysis. Furthermore, patients may present with hyperpronation of the rearfoot. This allows more of a ?teeter-totter? effect or
lack of motion control on the frontal plane of the calcaneus.
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 localised 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) are 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.
It is not difficult for a doctor to diagnose Sever's disease in a youngster or teenager. A personal history and a physical examination are usually all it takes to determine the cause of heel
Non Surgical Treatment
Depending on the Podiatrist's diagnosis and the severity of the pain, there are several treatment options available. Rest/ reduced activity: your child should reduce or stop any activity that causes
pain, such as sports and running. This can be a difficult option, as children are normally quite willful in pursuit of their favorite pastimes! Over the counter anti-inflammatory drugs, such as
ibuprofen (found in Nurofen), to help reduce pain and inflammation. Try to make sure your child does the recommended stretching exercises before sport/play. This will should help reduce the stress on
the fascia tendon and relieve heel pain. The use of Orthotic insoles. Footactive Kids orthotics are made for children. They will help properly support the foot, help prevent over-pronation or
improper gait restoring your child's foot the the correct biomechanical position. If you are in any doubt or your child's foot pain persists then please arrange an appointment with a Podiatrist or
Physiotherapist. Please click here for more information on the use of orthotics for children.
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