Sever's disease is an overuse syndrome involving an immature part of the skeleton. Pain goes away when the overuse is over, or when the growing is done. Hence, the disease is self-limited, in that
the pain goes away eventually when growth in the heel bone is complete at about age 13. Even if the child is hurting, as long as he can tolerate it, he may continue to take part in sports. No long
term disability is expected from this problem.
Sever's disease is a common cause of heel pain in physically active growing kids. It usually occurs during the growth spurt of adolescence, the approximately 2-year period in early puberty when kids
grow most rapidly. This growth spurt can begin anytime between the ages of 8 to 13 for girls and 10 to 15 for boys. Peak incidences are girls, 8 to 10 years old. Boys, 10 to 12 years old.
Pain in the lower calf and heel area which may be worse when applying pressure either side. Pain worse on activity especially those involving running or jumping. In severe cases this may cause the
child to limp when walking. One or both heels affected.
A doctor can usually tell that a child has Sever's disease based on the symptoms reported. To confirm the diagnosis, the doctor will probably examine the heels and ask about the child's activity
level and participation in sports. The doctor might also use the squeeze test, squeezing the back part of the heel from both sides at the same time to see if doing so causes pain. The doctor might
also ask the child to stand on tiptoes to see if that position causes pain. Although imaging tests such as X-rays generally are not that helpful in diagnosing Sever's disease, some doctors order them
to rule out other problems, such as fractures. Sever's disease cannot be seen on an X-ray.
Non Surgical Treatment
Initially, treatment will consist of resting from activity, ice and anti-inflammatory medications to reduce the pain. Your physiotherapist may also use a variety of pain reducing techniques such as
soft tissue massage or joint mobilisations. They may recommend taping to unload the area of pain, heel cups or wedge inserts into the bottom of your shoe. Also in the initial phase we may also refer
you to podiatry for orthotics and/or further footwear recommendations. It is also ideal in the first instance to start stretching your calf muscles and achilles. This initial phase typically lasts
for 1-2 weeks. During this time your physiotherapist will guide you on appropriate levels of activity- they may recommend you rest from impact type activities during this phase, and will guide you on
the best program to return to your sport without any further injury.
Sever?s disease is self-recovering, meaning that it will go away on its own when the foot is used less or when the bone is through growing. The condition is not expected to create any long-term
disability, and expected to subside in 2-8 weeks. Some orthopedic surgeons will put the affected foot in a cast to immobilize it. While symptoms can resolve quickly, they can recur. Sever's disease
is more common in boys than girls the average age of symptom onset is nine to eleven years.