Severs Disease
Severs disease (calcaneal apophysitis), is a common and painful condition affecting children between the ages of 8-14 years. The condition is defined by pain and swelling in the calcaneal apophysis (growth plate- defined by red arrows in the image) of the heel bone caused by traction from the calf/achilles tendon on the yet to fully fuse heel bone. In spite of its namesake, the condition is not a disease (and not contagious) and is very common in most active boys and girls.
Severs comonly appears in girls 8-12 years and boys 10-14 years when the secondary growth centre of the heel bone (the back part of the heel bone) is fusing to the main body of the heel bone. Unfortunately, the biggest tendon in the body, the Achilles Tendon, attaches to the smaller heel bone fragment and during growth spurts, and combined with high activity levels, it pulls on the growth centre causing pain and swelling.
The pain from Severs is self-limiting and will generally decrease with a decrease or cessation of exercise. While most children will decrease exercise due to pain, some will ‘run through’ the pain which is completely ok to do as this will not result in permanent problems.
Fortunately, there are a number of things parents and children can do to reduce the pain from Severs until the growth center eventually fuses. These include; pain relief medication, ice, exercise modification, heel raises – to take traction out of the calf/achilles, calf stretches to lengthen the muscle, orthotics (shoe inserts) to change forces acting on the growth plate and Achilles Tendon attachment point, and footwear changes – particularly changes to football boots that do not have any heel raise built in.
At Footwell Podiatry, our experienced podiatrists assess and treat all types of children’s foot problems. Severs Disease is the most common children’s foot condition presenting to our clinics. If your child has heel pain, book an appointment today.
