Sever’s is an inflammation of the growth plate in the heel of growing children. It typically affects children between the ages 8-14 years when their growth plates are busy growing. It is the most common growth plate issue , being far more common in boys than girls, and in those very active kids who participate in sports that involve running and jumping. Sever’s is also known as calcaneal apophysitis. Technically it’s not a disease but it was given this title a long time ago and it has stuck.
It is thought to be caused by:
tight Achilles and calf muscles
excessive impact forces through the heel, such as running and jumping
excessive pulling of the achilles tendon on the heel, such that which occurs through running and jumping activities
excessive pronated foot posture (feet that roll in)
high amounts of sporting activity, with no rest days (training overload)
That things that can contribute to the heel pain are:
Poor training practices, such as no warm-ups, cool down regimens
Footwear with no cushioning or raise under the heel, such as rugby boots
Poor everyday footwear, lacking in heel cushioning, support and heel raise
Rapid periods of growth
Hard ground, especially in dry months
The tell tales signs are:
pain around the back and sides of the heel, which can be worse with running, or at rest straight after activity.
limping after activity or walking tip toe to avoid the heel pain
Treatment
Treatment centers around reducing the stress on the heel and trying to limit the pulling of the achilles tendon on the heel. Any pain should have a thorough investigation and diagnosis by an appropriate health professional, such as a Podiatrist.
How can you help?:
RICE approach, especially icing the sore heels after activity
Light calf stretching
Checking and changing shoes if the cushioning and support under the heel has collapsed
Inserting heel raises into all shoes particularly those used for physical activity
Getting a podiatrist to assess your child’s walking and running pattern. It is thought excessive pronation puts additional strain on the heel and the achilles tendon that inserts around the growth plate area. Strapping or orthotics (arch supports) to help eliminate any abnormal foot function and strain on the heel
Reducing running and jumping activities on days when the pain is great.
It is often helpful to keep a pain diary to keep an accurate record of how symptoms are changing with treatment.
How long will it take to get better?
Anywhere from 2 weeks to months depending on how well you manage and apply the above.
Severs Disease is essentially a self limiting disorder. This means it will not occur once the bone has finished growing. That does not mean symptoms are not real or should be ignored.
If you have any further questions on this problem contact the clinic and make an appointment to see one of our podiatrists.