Sever's disease is a common cause of heel pain in children. While the condition can be painful and can come and go for months, or for a few years, it doesn't usually lead to any long-term problems.
Who gets Sever's disease?
Sever's disease often first appears in children when they are between 8 and 14 and growing rapidly. Highly active children are most at risk. Sever's disease is also known as calcaneal apophysitis.
What causes Sever's disease?
Sever's disease occurs when the bones in the calf (the tibia and fibula) grow more quickly than the Achilles tendon. This is the large tendon attached to the heel. The growth of the bones causes the tendon to become very tight, and results in the heel bone becoming sore and swollen.
During exercise, such as running and jumping, this tightness can place a lot of pressure at the back of the heel, leading to injury. Wearing sports shoes that have studs on the soles can increase the risk of Sever's disease.
You can reassure your child that the pain will disappear completely when the bone and tendon growth evens out.
Symptoms of Sever's disease
Sever's disease may affect one or both feet. Symptoms can include:
- pain or tenderness in the heel, during or after exercise
- swelling around the heel bone.
The symptoms usually get better with rest, but tend to come back again during exercise.
Diagnosis of Sever's disease
Diagnosing the cause of heel pain can sometimes be a challenge. Your health professional will usually start by asking some questions about where exactly the pain is and when it first appeared. They will also do a physical examination of your child's feet.
Tests such as x-rays or blood tests are not normally needed to diagnose Sever's disease.
Treatment of Sever's disease
There is no specific treatment for Sever's disease. Your doctor or physiotherapist may recommend that your child:
- temporarily stop doing activities that cause the heel pain
- use ice packs to reduce pain or swelling
- do calf stretches daily
- wear gel heel pads in their shoes
- wear comfortable shoes with good heel lift or arch support.
To ease the pain, children may need to cut down on sports that involve lots of jumping and running, such as soccer, basketball, netball or gymnastics. They can usually continue with low-impact activities like swimming and cycling. They can get back to normal after the pain eases.
Sever's disease can take between a few months and a few years to go away completely. Often it comes and goes, but there shouldn't be any lasting problems. The pain is usually over by 13 years of age in girls and by 14 years in boys, when the heel has finished growing.