The true name of this complaint is calcaneal apophysitis which just means an inflamation of the growth centre of the bone in your heel as a result of pulling by the Achilles tendon - it is important
to realise that it is not a disease but rather a condition that develops in the growing skeleton with activity. It is the most common cause of heel pain in young athletes, and is the second most
common condition of its kind in the younger athelete after Osgood-Schlatter's disease. It is often seen at a time of rapid growth during which the muscles and soft tissues become tighter as the bones
get longer. It occurs more in boys than girls and is seen most commonly between the ages of 8 and 14 years though it tends to be more prevalent in the younger of this group.
Sever?s disease is directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves a lot of heel movement. It can be associated with
starting a new sport, or the start of a new season. Children who are going through adolescence are also at risk of getting it because the heel bone grows quicker than the leg. Too much weight bearing
on the heel can also cause it, as can excessive traction since the bones and tendons are still developing. It occurs more commonly in children who over-pronate, and involves both heels in more than
half of patients.
The symptoms of Sever?s Disease may vary but usually include generalised pain and discomfort around the back of the heel. Can be one sided or both sides. Starts after child starts a new sport season.
May cause child to limp due to pain. Increases with weight bearing activity. Heel becomes red and can be swollen. X-rays are usually inconclusive and simply show the growth plate.
A Podiatrist can easily evaluate your child?s feet, to identify if a problem exists. Through testing the muscular flexibility. If there is a problem, a treatment plan can be create to address the
issue. At the initial treatment to control movement or to support the area we may use temporary padding and strapping and depending on how successful the treatment is, a long-term treatment plan will
be arranged. This long-term treatment plan may or may not involve heel raises, foot supports, muscle strengthening and or stretching.
Non Surgical Treatment
Please realize that the disorder may last only a couple of weeks to as long as 1-2 years. The treatment plan as prescribed by your doctor MUST be adhered to closely, and the activity level of the
child must be controlled during the early stages of treatment. All jumping and running sports, such as basketball, trampoline, volleyball, tennis, soccer, etc., must be eliminated as part of the
initial treatment. Once the child has improved and the pain has subsided, a rigid stretching program must then be implemented.
The following exercises are commonly prescribed to patients with Severs disease. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally,
they should be performed 1 - 3 times daily and only provided they do not cause or increase symptoms. Your physiotherapist can advise when it is appropriate to begin the initial exercises and
eventually progress to the intermediate, advanced and other exercises. As a general rule, addition of exercises or progression to more advanced exercises should take place provided there is no
increase in symptoms. Calf Stretch with Towel. Begin this stretch in long sitting with your leg to be stretched in front of you. Your knee and back should be straight and a towel or rigid band placed
around your foot as demonstrated. Using your foot, ankle and the towel, bring your toes towards your head as far as you can go without pain and provided you feel no more than a mild to moderate
stretch in the back of your calf, Achilles tendon or leg. Hold for 5 seconds and repeat 10 times at a mild to moderate stretch provided the exercise is pain free. Calf Stretch with Towel. Begin this
exercise with a resistance band around your foot and your foot and ankle held up towards your head. Slowly move your foot and ankle down against the resistance band as far as possible and comfortable
without pain, tightening your calf muscle. Very slowly return back to the starting position. Repeat 10 - 20 times provided the exercise is pain free. Once you can perform 20 repetitions consistently
without pain, the exercise can be progressed by gradually increasing the resistance of the band provided there is no increase in symptoms. Bridging. Begin this exercise lying on your back in the
position demonstrated. Slowly lift your bottom pushing through your feet, until your knees, hips and shoulders are in a straight line. Tighten your bottom muscles (gluteals) as you do this. Hold for
2 seconds then slowly lower your bottom back down. Repeat 10 times provided the exercise is pain free.