What is Severs Disease?

Severs Disease is also known as Calcaneal Aphophysitis. It is a painful bone disorder that results from inflammation and swelling of the growth plate in the heel. A growth plate is an area at the end of a growing bone where cartilage cells change over time into bone cells.

Severs disease is a common cause of heel pain in growing children, especially ones who are physically active. It commonly occurs during the growth spurt of children between the ages of 8 to 15 years of age.  

Symptoms

The most obvious and common symptom of Sever’s disease is pain and tenderness at the back of the heel. It can affect one or both heels.

• Swelling and redness of the heel
• Difficulty walking (often with a limp or on tiptoes to avoid putting pressure on the heel)
• Discomfort or stiffness in the feet
• Discomfort when the heel is squeezed on both sides

What causes it?

During the period of growth spurt, the heel bone sometimes grows faster than the leg muscles and tendons. This can cause the muscles and tendons to become very tight and overstretched, causing the heel to be less flexible and putting pressure on the growth plate. Over time, repeated stress (force and pressure) will result in swelling, tenderness diagnosed as Sever’s Disease.

The other cause of the pain in Severs disease is thought to be the tractional forces applied to the growth plate by the Achilles tendon at the insertion into the heel bone. This pulling force by the Achilles tendon on the growth plate is often aggravated by tight calf muscles and excessively pronated feet (feet that “roll in”).

* Pronated foot        

A foot that rolls in at the ankle when walking and running, which causes tightness and twisting/bowing of the Achilles tendon, which increases its pull on the heels growth plate.

* Flat or high arch foot

Having a flat or high arched foot affects the angle of the heel to the foot, causing tightness and shortening of the Achilles tendon.

Treatment

Treatment of Severs disease usually involves a combination of:

• Pain relief (often rest is required from sporting activities)
• Anti-inflammatory treatments such as application of ice/cold packs
• Stretching exercises
• Footwear assessment and advice
• Orthotics (arch supports) to change the ankle and foot alignment
• Heel cushions and heel raisers

Our biomechanical podiatrists can custom make orthotics to suit your child’s specific alignment issues. (The cost of these can be claimed on your health insurance under Podiatry extras)

Treatment of Severs disease does not require surgery. This foot condition responds very well to conservative treatment usually within 2 months. The sooner the symptoms are addressed the quicker the recovery. 

If your child is suffering from heel pain, call Kew Foot Clinic on 03 9853 6877 to make an appointment for the appropriate treatment.