Sever disease refers to a calcaneal apophysitis (an inflammation of the apophysis of the heel) which occurs in children and young adolescents. It typically presents in active young children (especially ones who engage in jumping and running sports).
Sever disease is more common in children who do regular sports or exercise that puts pressure on the heels. Activities such as running and jumping can put stress on the tight muscles and tendons.
The condition can be quite disabling and tends to affect those who are very busy with sporting activities. In the initial stages of the condition, most children displaying signs of Severs disease will tend to hobble or limp off the sports field or court and complain of sore heels near the end of activity. As the condition progresses, children may complain of pain during activity and in severe cases prior to sporting activities. Kids heel pain can be quite discouraging for active children but, early treatment can resolve this type of foot pain in children very quickly.
Your podiatrist will take a comprehensive medical history and perform a physical examination including a gait analysis. The assessment will include foot posture assessment, joint flexibility (or range of motion), biomechanical assessment of the foot, ankle and leg, foot and leg muscle strength testing, footwear assessment, school shoes and athletic footwear, gait analysis, to look for abnormalities in the way the feet move during gait, Pain provocation tests eg calcaneal squeeze test. X-rays are not usually required to diagnose Sever?s disease.
Non Surgical Treatment
The disease itself is self limiting and will resolve regardless of treatment once the growth plate has fully closed. Depending on the age of the youth at onset this could be a problem for many years. Treatment has always been aimed at managing the pain as well as the inflammation. This is done with the rest, ice, non steroidal anti-inflammatories like ibuprofen, stretching, taping, heel cups, heel lifts and orthotics. In severe cases, cast or walking boot immobilization is used. Each of these have differing levels of efficacy but in my experience orthotics are the golden treatment or the silver bullet. I am not talking about your run of the mill over the counter Dr. Scholls shoe insert. These definitely have their place in the world but not here. Custom molded orthotics made from a mold taken of the youths foot will provide the necessary control and support to stop the pain cycle. We can safely report over 85% of patients who are able to get back to sports and other activities as long as they wear the orthotics in supportive shoes as directed.