From the Research
Sever's disease, also known as calcaneal apophysitis, is a common cause of heel pain in physically active children and adolescents, characterized by inflammation of the growth plate in the heel bone due to repetitive stress and tension from the Achilles tendon, as reported in a recent case study 1.
Definition and Causes
Sever's disease typically affects children during growth spurts, usually between ages 8-14 for boys and 8-13 for girls, when bones grow faster than muscles and tendons, creating tightness and stress at growth plates. The condition is often associated with high-impact sports, obesity, and increased physical activity, as noted in a study published in 2019 2.
Symptoms and Diagnosis
Symptoms of Sever's disease include heel pain, tenderness, and swelling, which can be diagnosed through a physical examination, including a positive squeeze test, and radiographic imaging to exclude other differential diagnoses, as described in a study from 2021 3.
Treatment and Management
Treatment primarily involves rest from painful activities, ice application, over-the-counter pain medications, heel cups or cushioned insoles, and gentle stretching exercises for the calf muscles and Achilles tendon, with physical therapy recommended in more persistent cases, as outlined in a study from 2024 1. Some key points to consider in the management of Sever's disease include:
- Reducing athletic activity and avoiding high-impact sports
- Using soft bedding or heel cups in shoes to reduce pressure on the heel
- Stretching and strengthening exercises to improve flexibility and strength
- Monitoring and managing pain with over-the-counter medications
- Considering physical therapy for more severe or persistent cases Most children recover completely with conservative treatment within 2-8 weeks, and the condition typically resolves entirely when the growth plate closes during adolescence, with no long-term complications expected, as reported in a study from 1996 4.