Sever's Disease, also known as calcaneal apophysitis, is a common diagnosis in children often between the ages of 8-13 that affects the calcaneus or the heel bone. Inflammation forms around the growth plate which causes pain with activity. This is often diagnosed when a child is going through a growth spurt and often lasts weeks or months but may last for a couple of years. Once the growth plate has fused, there typically are no residual problems or pain. Often times with the diagnosis of Sever's Disease- a tight achilles tendon, calf muscle (gastrocnemius and soleus), and hamstrings is present. Activity/sports can aggravate the painful area. It is a similar condition to another commonly diagnosis in the knee often aggravated in children during growth periods called Osgood-Schlatter's Disease.
Signs and Symptoms
swelling and redness in the heel
difficulty walking
discomfort or stiffness in the feet upon awaking
discomfort when the heel is squeezed on both sides
an unusual walk, such as walking with a limp or on tiptoes to avoid putting pressure on the heel
pain on one or both heels often in the back and may extend into the foot to the arch
Management:
Sever's Disease can be a tricky condition as it may be bothersome one day and not on another. Stretching of the hamstring, calf, and foot are very important as well as rest when the pain flares up. Once the pain has subsided, activity may be resumed. Compression and ice are recommended to control the inflammation and pain as well as if no allergies or contraindications are present and your MD advises, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may also be helpful in controlling the acute pain and inflammation.
Another important factor to consider is that proper fitting shoes or sport specific footwear are very important. A medical professional such as a doctor, athletic trainer or physical therapist can assess the child's foot and help determine if an orthopedic insert may help. If a child is overweight, the child's doctor may recommend weight loss to decrease stress on the foot.
Resources:
http://kidshealth.org/parent/medical/bones/severs_disease.html
http://www.childrenshospital.org/az/Site3321/mainpageS3321P0.html
