Though it might sound severe, Sever's Disease is in fact not a serious illness, but rather an extremely common heel injury. Also known by its scientific name, Calcaneal apophysitis, which means 'heel tendon', the condition is defined as a painful bone disorder resulting from the inflammation or swelling of the growth plate in the heel.
This condition is most common in young adolescents; particularly girls from 8 to 10 years old and boys from 12 to 14 years old. During this time, when children are going through puberty and experiencing rapid growth, bones often grow faster than their supporting tendons and muscles. When coupled with cartilage that hasn't yet developed into mature bone, the result is tightness in their tendons and muscles which cause a lack of flexibility and strain on an undeveloped heel.
The unfortunate consequence of this is that, when participating in weight-bearing activities, or even just long periods of standing, the tight heel tendons may put too much pressure on the back heel. This build-up of pressure results in Sever's Disease.
Sever's Disease typically rears its ugly head at the commencement of a new sporting season, when adolescents are putting extra strain on their heels and tendons. Repetitive running or pounding on firm surfaces is especially hard on young heels, and for this reason, those involved in soccer, track, or basketball are especially vulnerable.
Other factors that can increase the risk of Sever's disease include a pronated foot (one that rolls at the ankle when walking), a high or flat foot arch, legs of uneven lengths, and obesity. A poor-fitting pair of shoes can also contribute to the condition, by not providing adequate support and/or padding for the feet.
Tenderness or pain in one or both heels is the most obvious sign of Sever's Disease. A child with the condition may begin to walk strangely, either limping or tip-toeing to avoid putting pressure on their heels.
Diagnosis of the condition is generally straightforward, and usually, a verbal description of the symptoms can provide an accurate identification of Sever's Disease. A 'squeeze test' may also be conducted to confirm the condition, which involves squeezing the back part of the heel to check whether this causes any pain.
As Sever's Disease does not tend to cause pain in adulthood, once the condition is diagnosed, the immediate goal of treatment is pain relief. Rest, which helps relieve pressure on the heel and thus decrease the associated swelling and pain, is usually the first thing prescribed. With proper care, Sever's Disease will generally disappear within 2 weeks to 2 months.
A doctor may also prescribe any combination of the following for Severe's Disease treatment:
- foot and leg exercises to stretch the tendons and strengthen the leg muscles;
- use of a compression stocking to decrease pain and swelling;
- over-the-counter anti-inflammatory and pain medication; and
- elevation of the foot for 20 minutes three times a day, coupled with ice, which helps reduce the inflammation and pain.
Although Sever's Disease heals quickly and does not cause long-term problems, it can recur in patients if measures aren't put into place to protect a child's growing heel. The most important preventive measure to ensure that the condition does not return is the use of high-quality sports shoes, with adequate support and padding.