Although the name might sound pretty frightening, Sever's disease is really a common heel injury that occurs in young people. It can be painful, but is only temporary and has no long-term effects The
condition occurs most commonly in children between the ages of 8 and 14 years but it can occur in younger children. It happens when the attachemnt of the Achilles tendon to the growth plate, becomes
inflamed and causes pain.
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.
Pain in the lower calf and heel area which may be worse when applying pressure either side. Pain worse on activity especially those involving running or jumping. In severe cases this may cause the
child to limp when walking. One or both heels affected.
This can include physical examination and x-ray evaluation. X-rays may show some increased density or sclerosis of the apophysis (island of bone on the back of the heel). This problem may be on one
side or bilateral.
Non Surgical Treatment
Consulting with a physiotherapist to confirm the diagnosis is important. Physiotherapist?s will advise on a management plan, usually consisting of activity modification (a reduction in playing and
training) and addressing the contributing factors as outlined above. Treatment may include relative rest/modified rest or cessation of sports, biomechanical correction, the use of heel wedges, soft
tissue massage, joint mobilisation, education, icing, taping, exercises addressing flexibility, strength or balance issues, footwear assessment and advice, a gradual return to activity program.
Stretching exercises can help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should do these
stretches 2 or 3 times a day. Each stretch should be held for about 20 seconds. Both legs should be stretched, even if the pain is only in 1 heel. Your child also needs to do exercises to strengthen
the muscles on the front of the shin. To do this, your child should sit on the floor, keeping his or her hurt leg straight. One end of a bungee cord or piece of rubber tubing is hooked around a table
leg. The other end is hitched around the child's toes. The child then scoots back just far enough to stretch the cord. Next, the child slowly bends the foot toward his or her body. When the child
cannot bend the foot any closer, he or she slowly points the foot in the opposite direction (toward the table). This exercise (15 repetitions of "foot curling") should be done about 3 times. The
child should do this exercise routine a few times daily.