Sever’s Disease
What is Sever’s disease?
Sever’s disease, often called Calcaneal Apophysitis, is a condition which involves the abnormal calcification (hardening) of a child’s heel plate. The hardening of a child’s heel plate is a part of their typical development and growth.
However, in the case of Sever’s disease, the Achilles tendon attaches to the heel plate during calcification, resulting in discomfort or pain. Sever’s disease typically occurs in children aged between eight and 15. Children that are taller or heavier in weight than average have an increased likelihood of developing Sever’s disease.
What causes Sever’s disease?
Although the known causes of Sever’s disease are limited, research shows there are several common causes, including:
– Added stress to the heel
– Interruption to the development of the heel plate. Wearing flat shoes can cause this interruption.
Here at Footfocus Podiatry, we are passionate about sharing our knowledge and experience with you so you can get back on your feet as soon as possible.
What are the symptoms of Sever’s disease?
When a child’s heel plate hardens, there may be a small amount of discomfort. However, when Sever’s disease is present, a child’s heel plate hardens quicker than usual or in a way that creates heel pain that may result in a limp or hindered mobility.
Our Footfocus Podiatry Approach
We would get an idea of the activity levels of your child and guide them on the best strategies pertinent to their sport(s)
We can then propose a treatment strategy which would involve Strength and conditioning, laser therapy, temporary custom orthotics, activity moderation and regular follow ups to ensure adequate resolution.
Book an appointment today for treatment and advice on managing Sever’s disease.
You can also book a Podiatry appointment for a comprehensive understanding of your child’s complete health for proactive and preventative advice and guidance.
You can also sign up to our newsletter for more information, offers and foot care advice from Footfocus Podiatry.
Sever’s disease is related to the natural development of your children’s feet as they enter adolescence. The primary treatments are:
Rest: Lessening your activity load. Avoiding jumping and running and taking up swimming instead, for example, will allow the inflammation to go down and for the pain to ease.
Ice: Wrapping ice in a towel (to protect the skin) and apply it to the affected area for a period of 15 minutes, especially after exercise.
Stop all sports activities until fully recovered. Continuing may only put excess pressure on the heel and cause further damage.
Elevation: Elevating the affected foot will decrease inflammation and remove pain, especially after exercise.
Pain relief: Medications can be prescribed to assist with pain relief.
Laser: We use laser therapy to reduce pain and speed healing of the bone tissue. Getting your child back to sport faster.
Custom Orthotics: These are a highly effective tool to use in the short term to stabilise the heel whilst providing cushioning thus allowing sport to commence.
Always wear shoes: Doing exercise barefoot can add to the trauma of the heel plate, making the condition worse.
Stretches: Stretches to the calf muscles for a period of 60 seconds three times a day and stretches the heel ligaments.
However, in the case of Sever’s disease, the Achilles tendon attaches to the heel plate during calcification, resulting in discomfort or pain. Sever’s disease typically occurs in children aged between eight and 15. Children that are taller or heavier in weight than average have an increased likelihood of developing Sever’s disease.
The best stretches to perform are:
The towel stretch – To perform the towel stretch, you should sit on a hard and flat surface, stretching out your legs in front of you. Put a towel around the balls of your feet one at a time and pull the towel towards yourself, ensuring your knees and back remain as straight as possible. Try to repeat this 3 times, holding for roughly 30 seconds per foot. This will help to stretch the heel cord and the bottom of the foot at once.
Range of motion ankle stretch – To do this stretch, you should imagine you are writing each letter of the alphabet using your foot, extending your toes outwards. Perform this exercise while sitting or lying down. This exercise will help to stretch your ankle in all different directions and should help to ease posterior heel pain.
The standing calf stretch – For this stretch, you will begin facing a wall, place your hands at roughly eye level against the wall and individually place one leg behind the other with the heel at the back, flat on the floor. Slowly turn the back leg slightly inwards and begin to lean into the wall until you feel a stretch in the back of your calf; try to hold this for roughly 30 seconds.
The strengthening exercises consist of:
Double heel raises – While holding onto something for stability, slowly lift both heels off of the ground, hold this position for roughly 5 seconds and then slowly lower yourself back down. Do this approximately 10-20 times twice a day. Once this becomes too easy, you can move onto singular heel raises.
Single heel raises – This exercise is the same as a double heel raise; however, in this instance, you will only be standing on one leg, so make sure you have something to hold on to for balance.
Lunges – Lunges are a great way to strengthen the overall ability of the lower limbs, and this will help to prevent further injuries in the future. To perform a lunge, place one foot in front of the other at a comfortable distance, and proceed to bend the front leg to a roughly 90 degree angle, keeping your back straight and stretching your back leg, lowering you to the ground. You should feel this stretch in the groyne of your back leg.