What is Sever’s disease?

Sever’s Disease

Sever’s disease also known as calcaneal apophysitis is one of the most common causes of heel pain in youth who are still growing. It is when there is inflammation present in the growth plate of the calcaneus (heel). Sever’s generally comes from repetitive stress to heel, so children who are highly active in sports tend to be more likely to suffer from Sever’s.

Risk Factors

  • Growing children and adolescents (9-13 years old)
  • Highly active in sports that involve large amounts of running or prolonged standing
  • Poor footwear choices
  • Flat feet
  • Weight
  • Barefoot on hard surfaces

Signs & Symptoms

Pain in generally located in the heel and often brought on by running, jumping or standing for long periods. It can occur bilaterally although one heel may be worse than the other. Swelling around the heel can sometimes occur due to inflammation around the growth plate. Pain is only normally experienced during activity and relieved with rest but can result in dull ache constantly.

Diagnosis

In most cases clinical assessment by your podiatrist can lead to diagnosis of Sever’s Disease, however in some cases imaging may be needed. This may include a X-Ray to check if there is any further damage to the calcaneus.

Differential Diagnosis

Soft tissue: Achilles tendinopathy, bursitis, plantar fasciitis

Skeletal: Stress fracture, arthritic changes, heel spurs

Neurological: Neuropathy, nerve entrapment, tarsal tunnel syndrome

Treatment

Conservative treatment will include; footwear education, heel pads/raises, stretching exercises, NSAID, orthoses, moonboot may be used in cases that are bad enough

Other more invasive treatments may be needed if there is no resolve including but not limited to;

  • Corticosteroid injections
  • Laser therapy
  • PRP injections
  • ESWT (Shockwave therapy)