Sever’s disease is a condition which can result in debilitating heel pain.
Sever’s disease is a condition which can result in debilitating heel pain. It affects kids and adolescents typically between the ages of 8 and 14. The condition is also known as calcaneal apophysitis, as there is inflammation and irritation of the growth plate (apophysis) in the heel bone (calcaneus).
This affliction is more common in kids who are highly active and participate in a lot of high-impact physical activity which involve running and jumping such as Aussie Rules Football or basketball. Kids may complain of pain during or after sport in the heel, instep and calf. They may also limp or toe walk to try to alleviate their symptoms. Pressing or squeezing the heel will also elicit symptoms and generally kids will feel better if they’ve rested.
Having very tight calf muscles can increase the tensile forces placed on the growth plate. Having abnormal foot posture or biomechanics can also be a contributing factor. Kids with flat feet can place more strain on the surrounding soft tissues whilst those with very high arched feet will have less shock absorbency and more direct pressure on the heel.
Self care includes resting the feet and reducing or modifying high-impact activity. This is key to a faster recovery in order to reduce irritation to the growth plate. Massaging the feet and calves along with gentle stretching will reduce any tightness and pull on the heel bone which gradually reduces pain. Applying a cold compress straight after activity will help with the initial inflammation, and transitioning to a heat pack later in the day or evening will also help with pain.
What our podiatrists will do when they suspect Sever’s is to perform a detailed biomechanical assessment in order to formulate a clinical diagnosis, as medical imaging is rarely indicated. From there, our discussions will provide a bespoke treatment plan based on the child’s activity and presentation. This includes:
- discussing load management on the heels
- return to activity plan
- strapping to offload
- exercise rehabilitation
- heel lifts
- appropriate footwear recommendations and modifications
- dry needling and massage
- over-the-counter or custom foot orthoses if needed
- low level laser therapy.
01 November Foot
Orthotics, Strapping, Foot, Footwear, PodiatricsView Video
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