What is Sever’s Disease?

Sever’s Disease (calcaneal aphophysitis) is not really a disease, but more a repetitious strain injury. This is the most common cause of kids heel pain seen at the Auckland Podiatry Clinic. Active children in football, soccer, basketball, netball and tennis with this type of foot pain complain of pain in the region of the heel bone particularly after exercise. In severe cases, children will complain of pain during exercise as well.

It is a frequent cause of heel pain in children, particularly in the very active child. It is most often seen in children between the ages of 8 to 15 yearsas the growth plate is not fully developed or calcified at this time.

What are the symptoms commonly seen with Sever’s disease?

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.

What causes kids heel pain?

The cause of the pain in Severs disease is thought to be the tractional forces applied to the growth plate of the heel bone by the Achilles tendon at the rear of the heel bone and the plantar fascia just beneath the heel bone. This pulling force by the Achilles tendon on the growth plate is often aggravated by tight calf muscles and excessively pronated feet (i.e. feet that “roll in” too far).

What is the best treatment for kids heel pain?

Treatment of Severs disease usually involves a combination of:

  1. An accurate analysis of your child’s gait, muscles, tendons, ligaments and joints is a crucial first step;
  2. Specific stretching and strengthening exercises often make up part of the treatment;
  3. Anti-inflammatory measures such as ice baths after exercise can be helpful in the short term;
  4. Footwear review, assessment and advice is important;
  5. Orthotic devices are often needed to firstly control any abnormal traction or tension on the heel growth plate and, secondly, too unload the ground reaction forces on the heel bone.

The Auckland Podiatry Clinic has podiatrists with specific paediatric training enabling them to utilise treatment options to relieve heel pain in children very quickly.

If your child is struggling to play sport, see a Auckland Podiatry Clinic podiatrist near you.

In severe cases modification to activity levels may be required.

Treatment of Severs disease does NOT require surgery. This foot condition responds very well to conservative treatment.