Sever?s disease is a common cause of heel pain in children especially in the young and physically active. Severs disease is a painful bone disorder that results from inflammation (swelling) of the
growth plate in the heel. A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the
growth plates expand and unite. It is very important that damage to the growth plate is avoided.
The heel bone grows faster than the ligaments in the leg. As a result, muscles and tendons can become very tight and overstretched in children who are going through growth spurts. The heel is
especially susceptible to injury since the foot is one of the first parts of the body to grow to full size and the heel area is not very flexible. Sever?s disease occurs as a result of repetitive
stress on the Achilles tendon. Over time, this constant pressure on the already tight heel cord can damage the growth plate, causing pain and inflammation. Such stress and pressure can result from,
Sports that involve running and jumping on hard surfaces (track, basketball and gymnastics). Standing too long, which puts constant pressure on the heel. Poor-fitting shoes that don?t provide enough
support or padding for the feet. Overuse or exercising too much can also cause Sever?s disease.
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
Sever disease is most often diagnosed clinically, and radiographic evaluation is believed to be unnecessary by many physicians, but if a diagnosis of calcaneal apophysitis is made without obtaining
radiographs, a lesion requiring more aggressive treatment could be missed. Foot radiographs are usually normal and the radiologic identification of calcaneal apophysitis without the absence of
clinical information was not reliable.
Non Surgical Treatment
stretching exercises can help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should do these
stretches 2 or 3 times a day. Each stretch should be held for about 20 seconds. Both legs should be stretched, even if the pain is only in 1 heel. Your child also needs to do exercises to strengthen
the muscles on the front of the shin. To do this, your child should sit on the floor, keeping his or her hurt leg straight. One end of a bungee cord or piece of rubber tubing is hooked around a table
leg. The other end is hitched around the child's toes. The child then scoots back just far enough to stretch the cord. Next, the child slowly bends the foot toward his or her body. When the child
cannot bend the foot any closer, he or she slowly points the foot in the opposite direction (toward the table). This exercise (15 repetitions of "foot curling") should be done about 3 times. The
child should do this exercise routine a few times daily.
Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling, in which the foot is pointed away from the body, then
curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever's disease. The curling exercise should be done in sets of 10 or 20 repetitions, and
repeated several times throughout the day.