Sever’s Disease

Heel pain is a concern that brings many patients to our offices at Foot & Ankle Associates of Florida. Our heels absorb a tremendous amount of force throughout the day. Heel pain is often explained by the simple fact there are several root causes. When it comes to our adolescent patients, their heel pain can frequently be attributed to a condition known as Sever’s disease (or calcaneal apophysis). This particular medical condition can be experienced in either foot, or sometimes both, but there is good news in the fact it is usually a temporary condition.Sever's disease occurs in adolescents

Sever’s Disease Cause and Symptoms

In spite of the misleading name, Sever’s is not actually a disease. Further, it is not an injury (even though there is somewhat of a link between the condition and physical activity). Instead, Sever’s disease is actually an issue that develops in response to differences in physical maturity between the calcaneus (heel bone) and the Achilles tendon (which connects to the back of the heel). More specifically, there is a growth plate located in the back of the heel which can develop more quickly than the Achilles and this results in a situation where the tendon and calf muscle (on its other end) become tight from excessive stretching.

The condition is most commonly seen in girls between the ages of 10 and 15 and boys between the ages of 8 and 13, but it can sometimes happen a little earlier or later than those age ranges. Physical activity may lead to increased pain and symptoms when Sever’s is present in patients of either gender. There are certain factors which can lead to an increase of symptom severity and presence, including ill-fitting shoes, excessive periods spent standing, and overuse.

Symptoms of calcaneal apophysis include:

  • Heel pain, which is the most prominent sign of this condition.
  • Swelling, redness, and tenderness (which is evident with a gentle squeeze at the back of the heel).
  • Difficulty or limping while walking.
  • Stiffness or discomfort in the back of the heel.

These symptoms can become more severe either during or immediately after physical activities. They will generally improve with rest.

Treating Sever’s Disease

Since Sever’s is caused by variances in the natural growth processes, treatment is concerned with providing relief from these painful symptoms.

Treatment options we may recommend include:

  • Reduced levels of physical activity – Activities causing pain need to be limited or perhaps even stopped altogether, depending on the circumstances.
  • Medication – In order to further relieve inflammation and pain for a patient, we may recommend or prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen. If your child is already taking over-the-counter medications, be sure to consult with us for appropriate dosages and specific recommendations.
  • Physical therapy – Various therapeutic modalities and stretching exercises may be quite beneficial in allowing the inflamed tissue to heal correctly.
  • Support for affected heels – In some cases, we recommend the use of shoe inserts or prescribe custom orthotics to better support the affected heel(s). These devices can help reduce pain and inflammation.
  • Immobilization – When rare cases bring severe pain, we may recommend immobilizing the area with the use of a cast.

Given the natural development processes, there really is no way to prevent Sever’s from occurring, but measures like wearing supporting footwear (especially for sports), limiting high-impact activities, and helping your child maintain a healthy body weight are proactive ways to reduce heel pain caused by this condition. These methods are useful for keeping excess pressure off of heels affected by calcaneal apophysis.

Fortunately, your child will simply grow out of this common cause of adolescent heel pain in time and without experiencing any long-term issues. In the meantime, though, our doctors at Foot & Ankle Associates of Florida can provide effective Sever’s disease treatment to relieve your child’s pain. Contact us by calling 407-339-7759 or 352-589-9550 (if you call from Lake County) for more information or to schedule an appointment for your son or daughter at any of our Orlando, Kissimmee, Tavares, Altamonte Springs, or Lake Mary offices.