Growing children and young athletes who run and play sports can develop severe heel pain from a condition called Sever’s disease. Specialists at the Children’s Health℠ Andrews Institute for Orthopaedics and Sports Medicine offer comprehensive treatments to ease Sever’s disease symptoms. We help athletes feel better faster so they can get back to the activities they love.
Overview
What is calcaneal apophysitis (Sever's disease) in children?
Typically impacting young athletes, calcaneal apophysitis usually affects children between ages 8 and 14 years old, as the heel bone is not fully developed until age 14. The heel growth plate (area of growing tissue at the end of long bones) suffers damage due to repeated trauma. This is because the Achilles tendon (tendon that runs along the back of foot above the heel) pulls the apophysis during activities. It typically occurs in both heels, but can also occur in only one heel.
Sever's disease was first described by James Warren Sever, an American orthopedic physician, in 1912.
Sever's disease was first described by James Warren Sever, an American orthopedic physician, in 1912.
Signs and Symptoms
What are the signs and symptoms of calcaneal apophysitis (Sever's disease) in children?
Symptoms of calcaneal apophysitis can include:
Heel pain during sports
Heel pain on one or both sides
Heel swelling
Limping
Pain when the heel is squeezed
Diagnosis
How is Sever’s disease diagnosed?
Sever’s disease causes symptoms similar to other overuse injuries like Achilles tendinitis and plantar fasciitis. An accurate diagnosis is critical to proper treatment and recovery. Our orthopedic specialists have deep expertise in diagnosing all types of overuse and sports injuries.
To diagnose Sever’s disease, our doctors:
Perform a physical exam, including a “squeeze test” of the heel to check for pain and tenderness
Evaluate symptoms
Refer to images from an X-ray, MRI or ultrasoundto check for stress fractures, tendinitis and other injuries
Causes
What are the causes of calcaneal apophysitis (Sever's disease) in children?
Calcaneal apophysitis can occur due to repeated trauma through the following:
Abnormal growth patterns where the bones grow faster than the soft tissue (muscles or tendons), which pull on the growth plate
Repeated running and jumping as the feet pound on hard surfaces (can occur in athletes who play basketball, soccer or track)
Additional strain from abnormal weight gain or obesity
Improperly fitted footwear or not enough support from shoes
Tight lower leg muscles, specifically in the calf and Achilles tendon
Flat feet or a high arch in the foot
Treatment
How is Sever’s disease treated?
We offer a full range of treatments for Sever’s disease. Our orthopedic and sports medicine specialists develop a customized treatment plan that eases heel pain while helping athletes remain as active as possible.
Cushioned heel cups and physical therapyexercises to stretch and strengthen the calf muscle and Achilles tendon are the primary treatments for Sever’s disease. Athletes may work with physical therapists in our sports rehabilitation program.
Other treatments for Sever’s disease include:
Applying ice to the heel
Limiting or stopping pain-inducing activities
Immobilization with walking boots
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Orthotics, such as cushioned heel cups and inserts