Sever's Disease (Calcaneal Aphophysitis) is not a disease, but a repetitious strain injury common in children between the ages of 8 and 14 years old. It is a common cause of heel pain, particularly
in the very active child. Patients with Sever's disease complain of pain in the bottom surface region of the back of the heel. This is where the growth plate is located, and is not fully developed or
calcified in a child's foot.
The actual pathology of the condition is one of more of an overuse syndrome in which the growth plate of the heel may become slightly displaced, causing pain. Biopsies of similar conditions have
shown changes consistent with separation of the cartilage. The cause of Sever's disease is not entirely clear. It is most likely due to overuse or repeated minor trauma that happens in a lot of
sporting activities - the cartilage join between the two parts of the bone can not take all the shear stress of the activities. Some children seem to be just more prone to it for an unknown reason,
combine this with sport, especially if its on a hard surface and the risk of getting it increases. A pronated foot and tight calf muscles are common contributing factors. The condition is very
similar to Osgood-Schlatters Disease which occurs at the knee.
Pain is usually felt at the back of the heel and around the sides of the heel. If you squeeze the back of the heel from both sides simultaneously and pain is experienced Sever?s disease is more than
To diagnose the cause of the child?s heel pain and rule out other more serious conditions, the foot and ankle surgeon obtains a thorough medical history and asks questions about recent activities.
The surgeon will also examine the child?s foot and leg. X-rays are often used to evaluate the condition. Other advanced imaging studies and laboratory tests may also be ordered.
Non Surgical Treatment
See a Podiatrist. Minimise inflammation, by the use of ice, rest and reduction of activity. Minimise pain with the use of anti-inflammatory medications. Shoes have been shown to attenuate shock and
reduce impact on the heel. Effective cushioning in the rear through specifcally placed cushioning units, such as GEL under the heel. A 10mm heel gradient that creates a more efficient foot posture
and therefore reducing strain on the lower limb. Sever's is self limiting and only possible when the growth plate is still present, and does not exist once the growth plates have closed. Podiatrists
have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.