Sever's disease is an injury to a child's still developing foot structure, specifically an inflammation in the heel's growth plate due to muscle strain and repetitive stress. It is common in young
athletes and children who have problems with pronation. Sever's Disease usually occurs in children age 8, 14 years of age when the child's bones are still in the growth stage and the growth plates
have not become ossified.
Sever condition is caused by sprain injury where the Achilles tendon attaches to the calcaneus bone at the back of the heel. Sever condition occurs in adolescent or older children, particularly
active boys. It can be very painful. It is one of those conditions commonly referred to as "growing pains." Patients are evaluated for signs of conditions that can mimic Sever condition, such as
ankylosing spondylitis and other forms of arthritis. Usually Sever condition is self-limited; that is, it disappears as the child ages.
Acute pain, pain asscoiatied with Sever?s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running. Highly active - children who are
very active are among the most susceptible in experiencing Sever?s disease, because of the stress and tension placed on their feet.
A physical exam of the heel will show tenderness over the back of the heel but not in the Achilles tendon or plantar fascia. There may be tightness in the calf muscle, which contributes to tension on
the heel. The tendons in the heel get stretched more in patients with flat feet. There is greater impact force on the heels of athletes with a high-arched, rigid foot. The doctor may order an x-ray
because x-rays can confirm how mature the growth center is and if there are other sources of heel pain, such as a stress fracture or bone cyst. However, x-rays are not necessary to diagnose Sever?s
disease, and it is not possible to make the diagnosis based on the x-ray alone.
Non Surgical Treatment
Sever?s disease treatment should be based on eliminating pain and restoring normal foot and leg biomechanics. As with most soft tissue injuries the initial treatment is Rest, Ice, and Protect. In the
early phase you?ll most likely be unable to walk pain-free. Our first aim is to provide you with some active rest from pain-provoking activities. "No Pain. No Gain." does not apply in Sever's
disease. If it hurts your child is doing too much exercise. Your child should reduce or cease any activity that causes heel pain. Ice is a simple and effective modality to reduce your pain and
swelling. Please apply for 20-30 minutes each 2 to 4 hours during the initial phase or when you notice that your injury is warm or hot. Most children can tolerate paracetamol as a pain reducing
medication. Check with your doctor. To support and protect your heels, you may need to be wear shock absorbing heel cups or a soft orthotic. Kinesio foot taping may help to provide pain relief.
For children with Sever's disease, it is important to habitually perform exercises to stretch the hamstrings, calf muscles, and the tendons on the back of the leg. Stretching should be performed 2-3
times a day. Each stretch should be performed for 20 seconds, and both legs should be stretched, even if the pain is only in one heel. Heel cups or an inner shoe heel lifts are often recommended for
patient suffering from Sever's disease. Wearing running shoes with built in heel cups can also decrease the symptoms because they can help soften the impact on the heel when walking, running, or