Sever’s disease is the common name for Calcaneal Apophysitis. It is a common cause of heel pain in the growing children population, particularly those that are active in sporting activities. As scary as the name may sound, it is not a disease, but is an over-used condition caused by repetitive strain of the calf muscle tendon (Achilles) on the growth plate within the heel bone. It’s name came from James Warren Sever (1878–1964), an American orthopedic doctor, who described it in 1912. If you think your child has Severs then please read on.
Who gets Severs?
This condition is more common in boys than girls and it tends to affect girls between the ages of 9 and 11 and boys between the ages of 11 and 14. 
Some of the contributing factors are:
- Tighter calf muscles and achilles tendon
- Abnormal foot function
- Abnormal gait patterns
- Inappropriate footwear (lack of support and cushioning)
- Rapid increase in height
- Sports that involve running and jumping activities on hard surfaces
- Sudden increase and change in activity levels
What are the symptoms for Severs?
The symptoms can vary from child to child but below are what you’d expect to find if Severs is present in your child.
- Pain presents largely when pushed at the heel. It may be associated with a discrete area of swelling at the back of the heel and can occur in one or both heels
- Pain can worsen during and after sporting activities such as running or activities that involve alot of jumping like basketball
- Pain can cause your child to limp and walking can be difficult when standing up after sitting
- Direct pressure over the sore heel from shoes can aggravate the symptoms
What can help reduce Severs pain?
Calcaneal Apophysitis (Severs) is a self-limiting condition which means it can go away on its own. However, the pain can be managed and treatment depends on the how much pain is present. 
You can try the following at home to help reduce pain for your child:
- Cold packs: apply ice or cold packs to the back of the affected heel for around 15 minutes after physical activity when a flare up occurs
- Activity modification: reducing pain-inducing activities for a short period of time to help reduce the inflammation
- Footwear protection: make sure your child is wearing supportive footwear to provide support and avoid further aggravating the painful heel.
How important is it to treat Severs?
While Severs can get better with time, it is hard to predict exactly how long it will take for the condition to resolve by itself. It could be up to two years or more during which time it may cause significant pain to your child and performance limitation in the sport that your child enjoys. If left untreated it can considerably limit even simple activities of daily life. So the short answer is, it’s important to seek help and professional advice if you think your child has Severs because it’s no fun seeing your child not being able to enjoy and do the activities they love.
How can a Podiatrist help my child with Severs?
At The Footcare Clinic, we will assess your child thoroughly by performing a detailed biomechanical examination and gait analysis. This will allow us to determine any underlying biomechanical contributing factors that need to be addressed and thus, improve your child’s symptoms and most importantly will allow them to return to their favourite sport as soon as possible.
Sever’s disease can be managed through strapping to reduce loading during sporting activities, foot support devices such as heel raises. Also, in-shoe wedging and orthotics to improve foot function and gait patterns has been shown to significantly reduce the pain. Stretching and strengthening exercises along with appropriate footwear modification will also help alleviate the condition.
If you’ve tried all the home remedies to help reduce pain for your child and it’s not working then don’t let them suffer heel pain any longer – give The Footcare Clinic a call today. We’re here to help!
