What is it?

Sever’s Disease (medically called Calcaneal Apophysitis) is a common cause of heel pain in young athletes, most commonly occurring between the ages of 8 and 15 years. It is common in sports involving running such as soccer, AFL, athletics and rugby. It is also common in sports involving repetitive impact such as gymnastics, jumping, basketball, netball and tennis. Sever’s Disease is also more prevalent after a “growth spurt” where the bones have grown quickly and the muscles are still stretching out to this new length.

Sever’s Disease causes pain at the back of the heel at the growth plate where the bone has not yet fully developed. Both the Achilles Tendon and the Plantar Fascia attach to the growing bone, making it subject to a lot of opposing pulling forces during weight bearing activities, running and impact activities. Poor mechanics of the foot (high or low arches, flat feet, etc) not only increase these opposing forces but can also increase the force of the heel striking the ground placing additional force through the growth plate. If the Achilles tendon it tight, often due to tight calf muscles, this can also increase the likelihood of Sever’s Disease.

4 Life Podiatry

Treatment for Sever’s Disease often requires the prescription of a custom, semi-rigid orthotic. This is not a hard fibreglass orthotic, but rather an orthotic to improve the shock absorption functioning of the feet. Soft tissue release throughout the calf may reduce the pulling from the Achilles Tendon, as will performing the exercises prescribed daily. Fortunately, Sever’s disease typically responds very well to Podiatry treatment and the condition is short lived, typically with no long term problems.

Prevention & Home Management Strategies

Where Sever’s Disease has been diagnosed, the following strategies will assist:

• Wearing supportive enclosed shoes with appropriate orthotics
• Resting from the offending activity such as running and sports
• Ice and anti-inflammatory medication (on the advice of your doctor)
• Stretching of the calf and hamstring muscles.