Sever’s disease or Calcaneal Apophysitis refers to an injury to the bone growth plate at the back of the heel bone (calcaneus) in young people, particularly those who are physically active. It usually develops in puberty and is slightly more common in boys than girls. It is the most common cause of heel pain in children.
How does it happen?
The large calf muscles attach to the heel via a large tendon called the Achilles tendon. The function of this tendon is to transmit forces produced by the calf muscles to the heel bone. In children, the portion of the heel bone into which the Achilles tendon inserts is separated from the bulk of the heel bone by a growth plate. This growth plate enables bone growth to occur. However, it also represents a site of weakness in the bone.
Forcible and repeated contraction of the calf muscles can injure the growth plate. This commonly occurs during a period of rapid growth where the muscles and tendons become tighter as the bones grow. This leads to increased pulling of the calf muscles and Achilles tendon on the heel bone and growth plate.
Contributing Factors to Sever’s Disease
Apart from the age of the young person, other factors that may contribute to developing the disease may include overuse (or too much physical activity). Your child’s heel pain may be caused by repeated stress on the heels (running and jumping activities), pressure on the back of the heel from too much standing or wearing poor-fitting shoes.
What should you do?
If you suspect your child has Sever’s disease you should seek assistance from your Podiatrist. In the meantime, you should limit their participation in sporting activities to restrict the amount of damage to the growth plate. It is not recommended to keep training or playing through injury. Ice packs after activity and changing to more supportive/cushioned footwear are also helpful.
Management
Your Podiatrist will assist in diagnosing the injury and the extent of the damage. From this, they will develop a management plan which may include rest or activity modification, soft tissue treatment such as massage and stretching, correction of biomechanics through heel raises or orthoses and the progression through a series of specific strengthening exercises.
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Understanding Sever's Disease in Active Children
Sever's Disease, also known as Calcaneal Apophysitis, is a common condition that affects physically active children, particularly those involved in sports. It occurs when the growth plate in the heel becomes inflamed due to repetitive stress, leading to heel pain. This condition is most prevalent in children aged 8 to 14 years, as they are often engaged in activities such as running and jumping that place excessive strain on the heel.
Parents should be vigilant for signs of heel pain in their children, especially if they are active in sports. Early recognition and intervention can help prevent long-term issues. Consulting a podiatrist for a proper diagnosis and management plan is crucial to ensuring a healthy recovery and continued participation in physical activities.
Causes and Risk Factors of Sever's Disease
Sever's Disease is primarily caused by the overuse of the heel, which can result from various factors including excessive physical activity, wearing improper footwear, and biomechanical issues. Children who participate in high-impact sports are at a greater risk, as the repetitive stress can lead to inflammation of the growth plate.
Other contributing factors include rapid growth spurts, which can make the heel bone more susceptible to injury, and inadequate warm-up or stretching routines before engaging in sports. Understanding these causes can help parents take preventive measures to protect their children from developing this painful condition.
Symptoms of Sever's Disease
The primary symptom of Sever's Disease is heel pain, which often worsens with activity and improves with rest. Children may also experience swelling or tenderness at the back of the heel, and they might limp or avoid putting weight on the affected foot. These symptoms can significantly impact a child's ability to participate in sports or physical activities.
It’s important for parents to monitor their child's complaints of heel pain and seek professional advice if symptoms persist. Early diagnosis and treatment can lead to a quicker recovery and help prevent further complications associated with untreated Sever's Disease.
Management and Treatment Options
Management of Sever's Disease typically involves a combination of rest, ice application, and modification of activities to reduce stress on the heel. A podiatrist may recommend specific exercises to strengthen the muscles around the heel and improve flexibility. In some cases, custom orthotics or heel lifts may be suggested to alleviate pressure on the growth plate.
In addition to professional treatment, parents can support their child's recovery by ensuring they wear appropriate footwear and limit high-impact activities during the healing process. Following a structured rehabilitation plan can help children return to their favorite sports safely and effectively.
