Sever?s disease is irritation of the growth plate in the heel. If rest is prescribed by your doctor, you should probably listen! But, there is usually an underlying cause of this irritation, and we need to address what?s causing it if we don?t want it to come back the first time an athlete jumps, runs, or kicks a ball.
Physically active children run the risk of developing Sever?s disease because they put the most strain on their growing bones. Sever?s usually occurs during the adolescent growth spurt, when young people grow most rapidly. (This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys.) By age 15 the back of the heel usually finished growing. As teens grow, the growth plates harden and the growing bones fuse together into mature bone. Young people engaged in physical activities and sports that involve jumping and running on hard surfaces-such as track, basketball, soccer, and gymnastics-are ata higher risk for developing Sever?s disease. Poor-fitting shoes can contribute by not providing enough support or padding for the feet or by rubbing against the back of the heel.
As a parent, you may notice your child limping while walking or running awkwardly. If you ask them to rise onto their tip toes, their heel pain usually increases. Heel pain can be felt in one or both heels in Sever's disease.
The x-ray appearance usually shows the apophysis to be divided into multiple parts. Sometimes a series of small fragments is noted. Asymptomatic heels may also show x-ray findings of resporption, fragmentation and increased density. But they occur much less often in the normal foot. Pulling or ?traction? of the Achilles tendon on the unossified growth plate is a likely contributing factor to Sever?s disease. Excessive pronation and a tight Achilles and limited dorsiflexion may also contribute to the development of this condition.
Non Surgical Treatment
Occasionally, an orthotic may need to be prescribed for temporary or long-term correction of their foot biomechanics (eg flat feet or high arches). During the acute phase of Sever's disease a small heel rise or shock-absorbing heel cup placed under the heel pad of your child's foot may help to ease the symptoms. Your podiatrist or physiotherapist can assess your child's arch and guide you in the best management of your child's condition. We recommend that your child should never go barefooted during the painful stages of Sever's disease.
Properly stretching to maintain flexibility is effective for preventing Sever's disease. Stretches should target the calves, heel cords, and hamstrings. Your child should do the appropriate stretches two or three times a day, holding the stretch for about 20 seconds each time. Ask your child's doctor for specific exercise instructions. Generally, doctors advise stretching both legs, even if the pain is confined to one heel. It's also helpful to strengthen the shin muscles by having your youngster pull his toes in with a rubber exercise band or a piece of tubing and then stretch them forward. Assist your child in doing 15 repetitions of this exercise, three times a day. Having your child wear shoes with good shock absorbers and avoid running on hard surfaces as much as possible should also help prevent the condition.