Sever's Disease
Sever’s disease, also known as calcaneal apophysitis, is a common heel injury that occurs in active children and adolescents. It is not a true “disease” but rather a condition that affects the growth plate in the heel bone. Understanding the causes, symptoms, diagnosis, and management of Sever’s disease is crucial for parents and young athletes. In this article, we will explore Sever’s disease in detail.
Understanding Sever’s Disease
Anatomy of the Heel
To understand Sever’s disease, it’s essential to know the anatomy of the heel:
- Growth Plate: The growth plate, also known as the epiphyseal plate, is an area of developing tissue near the end of long bones.
Causes of Sever’s Disease
Sever’s disease occurs when there is repetitive stress on the growth plate in the heel bone. Common causes include:
Physical Activity: Sports that involve running and jumping, such as soccer, basketball, and gymnastics, can contribute to the condition.
Growth Spurts: Rapid growth during adolescence can temporarily outpace the development of the Achilles tendon, leading to tension and stress on the growth plate.
Foot Mechanics: Abnormal foot mechanics, such as flat feet or high arches, can increase the risk of Sever’s disease.
Symptoms of Sever’s Disease
Common symptoms of Sever’s disease include:
Heel Pain: Pain and tenderness in the back of the heel, especially during or after physical activity.
Limping: Children may limp to alleviate heel pain.
Stiffness: The heel may feel stiff or sore upon waking in the morning.
Swelling: Some swelling may be present around the heel area.
Diagnosis and Treatment
Diagnosis
Diagnosing Sever’s disease typically involves:
Medical History: Discussing symptoms, activity level, and medical history.
Physical Examination: Evaluating the heel for tenderness and pain.
Treatment
The treatment approach for Sever’s disease includes:
Rest: Reducing or avoiding activities that exacerbate the condition to allow the growth plate to heal.
Icing: Applying ice to the affected area to reduce inflammation and pain.
Stretching and Strengthening Exercises: Gentle calf and Achilles tendon stretching exercises can help alleviate tension on the growth plate.
Footwear: Wearing supportive shoes with proper arch support and cushioning.
Orthotic Inserts: Using orthotic inserts or custom-made orthotics to provide additional support.
Medications: Over-the-counter pain relievers or anti-inflammatory medications may be recommended for pain management.
Physical Therapy: Working with a physical therapist to improve foot mechanics and muscle strength.
Heel Cups or Pads: These can provide cushioning and reduce pressure on the heel.
Temporary Activity Modification: Reducing the intensity or frequency of sports or activities during the healing phase.
Prevention
To reduce the risk of Sever’s disease or prevent its recurrence:
Encourage proper warm-up and stretching before physical activities.
Ensure that children wear well-fitting shoes with adequate arch support.
Monitor activity levels to avoid overtraining or excessive stress on the heels.