What Is Sever’s Disease? Everything You Need to Know

November 14, 2024

What Is Sever’s Disease? Everything You Need to Know

Sever’s disease is heel pain in children caused by inflammation. You can count on kids to do two things — grow and jump around. Unfortunately, these are two contributing factors to Sever’s disease. The condition can develop during a growth spurt when the bones grow faster than the Achilles tendon can lengthen. If the tendon is too tight, it puts pressure on the growth plate in a child’s heel, causing pain. High-impact sports like running or jumping can worsen the pain.

This condition can be painful, but it heals with time. Early diagnosis and treatment can help get your child back on their feet.

What Is Sever’s Disease?

Sever’s disease, or calcaneal apophysitis, is painful inflammation at the back of the heel (calcaneus). It affects the areas of new bone growth at the end of long bones called growth plates. While children are growing, the growth plates are soft and rubbery but harden over time. Repeated stress or pressure irritates the growth plate, causing pain and inflammation.

Although the name suggests otherwise, Sever’s disease is classified as an injury rather than a disease. It affects growing children between the ages of 8 and 15.

What Are the Symptoms of Sever’s Disease?

If your child has any of the following symptoms, it may point to Sever’s disease:

Heel pain: The most common symptom is soreness at the back of the heel, which may come and go. Sever’s disease may cause pain in only one foot, but up to 60% of patients experience pain in both feet.
Pain that increases with activity: Pain may worsen during sports activities like running or jumping. It may also be more tender when they wake up and get better with rest.
Limping: You may notice your child walking on their toes or limping to avoid pressure on their heels.
Inflamed heels: Swelling, redness or irritation in the heels may indicate injury.
Pressure intolerance: Pressing or squeezing the heel may cause pain or discomfort.

The symptoms of Sever’s disease may be similar to other conditions. A health care practitioner can provide a proper diagnosis.

What Causes Sever’s Disease?

Repeated stress on the heel’s growth plate causes Sever’s disease. The Achilles tendon is a band of tissue that connects the heel bone to the calf muscles. The tendon tightens when the bones grow faster than the tendon can stretch. Activities that pull on the tendon can irritate and inflame it.

Growth spurts contribute to Sever’s disease. During a growth spurt, your child’s height increases faster. Girls typically experience significant growth between 8 and 13 years old and boys between 10 and 15 years old.

High-impact activities like running, jumping and sports put extra pressure on the heel. This added impact can irritate the growth plate, causing further inflammation.

Who Is at Risk of Sever’s Disease?

Sever’s disease affects only children and adolescents. When adults experience heel pain, it’s likely Achilles tendinitis or plantar fasciitis. Between 2% to 16% of children’s musculoskeletal complaints are due to Sever’s disease.

Active kids who play sports on hard surfaces are at higher risk of developing the condition. Common sports contributing to Sever’s disease include basketball, track, soccer and gymnastics. Running and jumping can cause more tension on already tight tendons and muscles.

How Is Sever’s Disease Diagnosed?

It’s best to take your child to a medical practitioner if they have pain or swelling in their heels. Your doctor will examine the foot, including pressing on the bottom and sides of the heel bone. They may ask your child to perform movements like jumping or walking.

The doctor may request an X-ray or foot imaging test to rule out fractures or other conditions.

What Is the Treatment for Sever’s Disease?

Sever’s disease treatment centers around at-home pain and inflammation relief. The standard treatments include:

Pain relievers: Applying ice packs to the heels can help ease pain and swelling. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, can also help.
Rest: During recovery, your child must pause sports and other physically demanding activities. Your doctor can recommend how long to avoid these activities.
Heel pads: Gel pads inserted into shoes help absorb shock and lessen stress on the heel.
Stretching: Specific stretching exercises can help release tightness and strengthen the muscles. Speak to your health care provider for guidance.
Podiatry: A podiatrist specializes in treating foot and ankle conditions. These doctors have experience in juvenile foot injuries such as Sever’s disease. They may recommend exercises or orthotics to reduce pressure on the growth plate.
Physical therapy: A physical therapist uses exercises and other treatments to manage pain. These exercises can also strengthen the ligaments, increasing your child’s range of motion.
Orthopedic shoes: Supportive footwear provides comfort and relief from Sever’s disease pain. Made from a mold of your child’s foot, custom orthotics protect the heel and support the foot arch. An alternative is podiatrist-designed Vionic shoes, which relieve pain and restore foot function.
Cast or splint: If your child has pain after weeks of rest, the doctor may recommend a cast or splint. A cast immobilizes the foot to protect the growth plate and allow it time to heal.

How Long Does Sever’s Disease Take to Heal?

With enough rest, your child should recover from Sever’s disease within two to eight weeks. It’s essential to take your child to a health care provider if the pain worsens or your child develops a fever.

Since the condition affects growing bones, it resolves once your child’s bones fully develop and the growth plates close.

Can You Prevent Sever’s Disease?

The following best practices can reduce your child’s risk of developing Sever’s disease:

Weight management: Maintaining a healthy weight can lower the chance of heel injury. A healthy diet and active lifestyle can help prevent weight-related foot issues.
Wearing the right footwear: Using the proper footwear for a sport reduces pressure on the heel.
Taking activity breaks: If your child’s heels are swollen or in pain, suggest they take some time off from sporting activities.
Alternating sports: Varying low- and high-impact activities limit stress on the growth plate. For example, your child might alternate between playing basketball and swimming.

Contact Foot & Ankle Surgical Associates for Sever’s Disease Treatment

At Foot & Ankle Surgical Associates, we know that the best part of being a kid is running, jumping and playing. That’s why our expert podiatry team focuses on getting children back on their feet fast. We specialize in treating heel pain, such as Sever’s disease and other foot issues.

Our treatments include cutting-edge diagnostics, tailored plans and custom orthotics. We are proud to serve patients in Centralia, Lacey, Olympia, Tacoma and Tumwater.

Let us help your child give Sever’s disease the boot! Call us at 360-754-3338 or contact us online to book an appointment.