Also known as calcaneal apophysitis, Sever’s disease occurs during growth spurts, when bones, muscles, tendons, and other structures are rapidly changing. Sever’s disease happens when the growth plate in the back of the heel becomes inflamed and painful.

Growth plates are funny things, they are areas of cartilage, a rubbery and flexible material, mostly found near the end of long bones in the body. Growth plates harden and become solid bone towards the end of puberty which is why Sever’s disease only occurs in pre-pubescent or pubescent children.

What are the main symptoms?

Sever's disease usually causes pain or tenderness in one or both heels and may also cause the following:

• Tenderness and pain that gets worse with activities that involve running or jumping
• Stiffness in the heels first thing in the morning
• Redness, swelling and irritation in the heel or heels

Sever’s disease falls into the category of repetitive stress injuries.

How is Sever's disease diagnosed?
A podiatrist will discuss your child's symptoms, general health and activity levels. The practitioner will thoroughly examine your child's feet and ankles for tenderness and swelling – paying particular attention to the area around the heel bone. Scans or x-rays may be requested to rule out other conditions.

What is the treatment?
Much to the horror of many children the treatment for a child with Sever's disease is to reduce or avoid activities that cause pain for a set period of time. Walking and non-weight bearing exercises (like swimming) are usually permitted.

They may also be advised to:

• Use ice or cold packs on the heel
• Introduce daily stretching and strengthening exercises
• Wear appropriate and supportive footwear
• Use heel gel cups or orthotics to relieve pressure on the heel
• Take pain-relief medicine for the short term, if required
• Undergo ultrasound or laser therapy for pain management

The Good News!
Sever's disease usually gets better within months with no long-term problems. Most kids can do all of the sports and activities that they did before the condition flared up. Wearing sports shoes that provide good support to the foot and heel help to prevent recurrence.

By the time your child is 15 years old the growth plate in the heel has matured into solid bone, meaning they won't ever get the condition again.

In Summary

• Sever's disease is a common cause of heel pain in active children and adolescents
• Sever’s disease happens when the growth plate in the back of the heel becomes inflamed
• Pain is normally worst when the sufferer is active. Stiffness, redness, and swelling can also be present in the heel area
• To diagnose, a podiatrist will review your child's symptoms, general health, and activity levels
• Treatment requires a temporary reduction in activity as well as other strategies to resolve the condition
• Once a child has been through puberty, they will not suffer from the condition again