Serafina Adjutant

Overview


Sever's disease is a term used to describe inflammation of the calcaneal apophysis which occurs in children and adolescents. Sever first described the condition in 1912. Further studies have suggested that the condition is due to repeated 'microtrauma' at the site of the attachment of the Achilles tendon to the apophysis of the heel, often as result of sporting activities. The disorder can be classified among the general osteochondrosis syndromes such as Osgood-Schlatter disease.


Causes


Heel pain can also be caused by a stress fracture in the heel, bursitis, tendonitis, bone cysts, and rheumatologic disorders. If the athlete is not active in impact sports or is not between age 9 and 13 years, other conditions should be considered.


Symptoms


Most children with Sever's complain of pain in the heel that occurs during or after activity (typically running or jumping) and is usually relieved by rest. The pain may be worse when wearing cleats. Sixty percent of children's with Sever's report experiencing pain in both heels.


Diagnosis


It is not difficult for a doctor to diagnose Sever's disease in a youngster or teenager. A personal history and a physical examination are usually all it takes to determine the cause of heel pain.


Non Surgical Treatment


Consulting with a physiotherapist to confirm the diagnosis is important. Physiotherapist?s will advise on a management plan, usually consisting of activity modification (a reduction in playing and training) and addressing the contributing factors as outlined above. Treatment may include relative rest/modified rest or cessation of sports, biomechanical correction, the use of heel wedges, soft tissue massage, joint mobilisation, education, icing, taping, exercises addressing flexibility, strength or balance issues, footwear assessment and advice, a gradual return to activity program.


Recovery


This condition is self limiting - it will go away when the two parts of bony growth join together - this is natural. Unfortunately, Sever's disease can be very painful and limit sport activity of the child while waiting for it to go away, so treatment is often advised to help relieve it. In a few cases of Sever's disease, the treatment is not successful and these children will be restricted in their activity levels until the two growth areas join - usually around the age of 16 years. There are no known long term complications associated with Sever's disease.