What is Sever’s disease?
Sever’s disease is better known as adolescent heel pain. The tendons and ligaments in our body mature slower than our bones. This causes our soft tissue to be over worked as it attempts to compensate for the larger bone. The calcaneus, the heel bone, is no exception this phenomenon. In an active child, the muscles are over strained and stretched at the bones growth plate the feet causing pain and swelling most notably at the back of the heel.
Who gets it the most?
Kids are most at risk during the early part of their growth spurts. Physically active boys around 10-12 years old and in girls around 8-10 can suffer from Sever’s disease. Older teens rarely are affected as their feet are skeletally mature and no longer have growth plates at that age.
What are the symptoms?
Any pressure on the bottom or back of the heel will cause pain in a child suffering from Sever’s Disease. He or she will limp or tip toe to avoid walking on the painful area. These symptoms usually develop at the beginning of a sports season or any sudden increase in activity. Parents may find redness and swelling in the back of their kid’s heels. Some children will have trouble sleeping at night due to night pains as their heels are resting on the bed.
How do we test/diagnose?
A thorough exam by a podiatrist will help make the diagnosis. Your child will be asked about their habits and physical activity level. Applying pressure to the problematic area often provides the diagnosis. Additional imaging and having your child go through certain motions will help rule out other knee issues.
How do we treat? How do we prevent?
Sever’s disease is self limiting with proper care. In addition to resting, icing and anti-inflammatory medication, orthotics is the first line of treatment. Routinely stretching out any tight tendons and ligaments in the foot and ankle may not only treat but also prevent any future occurrences. Activity appropriate shoes should be worn to provide optimal support. Custom orthotics are very helpful in supporting any flat or high arches that can otherwise cause the foot to be over worked. In severe cases where patients are not showing improvement, a cast or protective boot is used to allow the foot and ankle to completely rest from any motion that can aggravate the injury.