Coping With Severs DiseaseOverview
Sever?s disease is a painful condition of the heel affecting children, usually at the beginning of the growth spurt in early puberty. It is caused by inflammation at the growth plate at the back of the heel, adjacent to the Achilles tendon attachment. This is one of the most common causes of heel pain in school-aged children. Physically active children aged between eight and fourteen years old are most at risk of developing pain from Sever?s disease. It is common among children involved in soccer, little athletics, gymnastics, basketball and netball but can affect children involved in any running or jumping activity. Boys seem to be more commonly affected than girls.
Sever?s is often present at a time of rapid growth in adolescent athletic children. At this time the muscles and tendons become tighter as the bones become larger. Between 8 - 15 years of age is the usual onset of this condition.
The most common symptoms of Sever?s involves pain or tenderness in one or both heels. This pain usually occurs at the back of the heel, but can also extend to the sides and bottom of the heel. A child with Sever?s may also have these common problems. Heel pain with limping, especially after running. Difficulty walking. Discomfort or stiffness in the feet upon awaking. Swelling and redness in the heel. Symptoms are usually worse during or after activity and get better with rest.
A doctor or other health professional such as a physiotherapist can diagnose Sever?s disease by asking the young person to describe their symptoms and by conducting a physical examination. In some instances, an x-ray may be necessary to rule out other causes of heel pain, such as heel fractures. Sever?s disease does not show on an x-ray because the damage is in the cartilage.
Non Surgical Treatment
The physiotherapist will thoroughly assess the affected areas and general mechanics to determine what factors may be contributing, also to rule out any other injuries or stress fractures, etc. Treatment focusing on the affected area will consist of modified rest, ice, massage, stretches and electrotherapy. A foam heel raise may also be given to help decrease pain. The physiotherapist may also treat other areas if biomechanical problems are noted. This may include massage, mobilization and exercises to stretch and strengthen certain areas. They may also refer the patient to see a podiatrist if they believe the foot posture is a factor.
This condition is self limiting, it will go away when the two parts of bony growth join together, this is natural. Unfortunately, Sever's disease can be very painful and limit sport activity of the child while waiting for it to go away, so treatment is often advised to help relieve it. In a few cases of Sever's disease, the treatment is not successful and these children will be restricted in their activity levels until the two growth areas join, usually around the age of 16 years. There are no known long term complications associated with Sever's disease.