During a growth spurt, your child?s heel bone grows faster than the muscles, tendons, and ligaments in her leg. In fact, the heel is one of your child?s first body parts to reach full adult size.
When the muscles and tendons can?t grow fast enough to keep up, they are stretched too tight. If your child is very active, especially if she plays a sport that involves a lot of running and jumping
on hard surfaces (such as soccer, basketball, or gymnastics), it can put extra strain on her already overstretched tendons. This leads to swelling and pain at the point where the tendons attach to
the growing part of her heel.
Young athletes typically sustain the injury due to repeated stress caused by running and jumping. Partaking in any high speed sports can thus partly provoke the condition, such as football, rugby,
basketball, hockey or track athletics. Crucially the injury is linked to overuse, so exercising with fatigued leg muscles, without a suitable warm up, or beginning a new strenuous physical activity
are all risk factors. Placing excessive weight or pressure on the heel can also cause the injury. Another factor related to Sever's disease is overpronation, a biomechanical error that makes the foot
roll too far inwards.
Pain is usually related to activity levels. In most cases the posterior aspect of the calcaneus will be tender. Checking both the medial and lateral aspects of the posterior portion of the growth
plate will often show tenderness. Occasionally, the plantar aspect may be tender or both of these locations may be found to be tender. Frequently the Achilles tendon is tight and there may have been
a recent increase in activity. The factors contributing to this disorder are similar to those causing plantar fasciitis, but a tight Achilles tendon appears to be a greater contributor than
A doctor can usually tell that a child has Sever's disease based on the symptoms reported. To confirm the diagnosis, the doctor will probably examine the heels and ask about the child's activity
level and participation in sports. The doctor might also use the squeeze test, squeezing the back part of the heel from both sides at the same time to see if doing so causes pain. The doctor might
also ask the child to stand on tiptoes to see if that position causes pain. Although imaging tests such as X-rays generally are not that helpful in diagnosing Sever's disease, some doctors order them
to rule out other problems, such as fractures. Sever's disease cannot be seen on an X-ray.
Non Surgical Treatment
Sever?s disease is a self-limiting problem, because as your child grows the growth plate will eventually fuse with the main body of the heel bone. This happens at about 14 -15 years of age. Once foot
growth is complete and the growth plate has fused, the symptoms will resolve. In the meantime, treatment by your Podiatrist will help your child return to normal sporting activities without heel pain
slowing him/her down.
Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling, in which the foot is pointed away from the body, then
curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever's disease. The curling exercise should be done in sets of 10 or 20 repetitions, and
repeated several times throughout the day.