Sever's disease

A common cause of foot pain in children and adolescents is a condition referred to as Sever’s disease. It is also known as calcaneal apophysitis.

This problem results in pain in one or both heels, particularly with activity.

Sever’s disease is common amongst physically active children who participate in high impact sports involving jumping or sprinting (e.g. football, basketball, soccer, athletics, netball).

Excessive forces placed on the heel bone at the site where the Achilles tendon inserts leads to inflammation of the growth plate of the bone.

The condition is more prevalent in the early stages of puberty and generally effects females between the ages of 8 – 13 and males from 10 – 15.

Sever’s disease is similar to Osgood-Schlatter disease, a condition affecting the bones in the knees.

Causes

• Overactivity or increased training load
• Flat feet or high-arched feet
• Tightness of calves and Achilles tendon
• Playing on hard surfaces
• Poor or unsuitable footwear
• Obesity

Signs and symptoms

• Pain on the back or sides of the heel bone or around the Achilles tendon
• Pain in the heel with activities involving explosive movements, i.e. jumping, running/sprinting
• Pain can be worse initially after activity but generally settles after rest
• Limping when walking or running
• Tender or painful to touch

Treatment

• Rest
• Reduction or modification of activity levels for a short period
• Ice or heat to the area
• Biomechanical assessment by a podiatrist
• Orthotic insoles may be required for flat or high-arched feet
• Stretching of calves and Achilles