When recurring heel pain occurs in children, it is usually due to Sever's Disease, while adult heel pain is usually due to heel spurs, plantar fasciitis, or retrocalcaneal bursitis (Haglund's
Deformity). Calcaneus is the anatomical name of the heel bone. Sever's Disease or Calcaneal Apophysitis is an inflammation of the growth plate located at the posterior aspect (back) of the
Severs disease arises due to a traction of the Achilles Tendon from the heel bone or from excessive impact forces to the area during peak growing periods. Most children will present with one or many
of the following backgrounds. Recent periods of rapid growth/changes of body mass/strength. Overuse, Multiple sporting clubs, multiple sports, high intensity of training. Poor footwear (insufficient
heel height). Training errors. Tight surrounding muscles. Osseous growth proceeds that of the soft tissue. Poor biomechanics and posture (excessive pronation/flat feet).
Sever condition causes pain at the back of the heel. The pain is increased with plantar flexion of the ankle (pushing down with the foot as if stepping on the gas), particularly against resistance.
Sever condition also causes tenderness and swelling in the area of the pain.
Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as
it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.
Non Surgical Treatment
If your child lets you know that his heels are hurting, schedule a doctor's appointment. Your family doctor may or may not refer you to a podiatrist. Treatment for Sever's Disease typically consists
of one or more of the following steps. Reducing physical activity. Because Sever's Disease appears to be most common in athletic children, reducing exercise periods will relieve pressure on the heel
bones, thereby reducing pain. Your doctor may recommend that your child take a complete break from athletic activity for a set amount of time. Icing the heel bones can help to lower both inflammation
and pain levels. Use a cold pack or wrap ice in a towel and apply it to the heels. A new exercise regimen that involves simple stretches designed to lengthen the calf muscles and tendons. Your doctor
may prescribe the use of orthotic shoe inserts that will assist your child in maintaining a good level of physical activity. HTP Heel Seats may be an excellent option and have been purchased by many
parents as an effective aide for children suffering from Sever's Disease. Read about HTP Heel Seats here and ask your doctor if they are right for your child's unique case. In extreme cases, a doctor
may recommend a plaster cast or boot, but typically only if other less cumbersome solutions fail to reduce pain. Some doctors may prescribe anti-inflammatory medications. Never give these to a child
yourself, without first seeking a doctor's advice. Some medications carry the risk of serious side effects for children. Only give medications if specifically prescribed your child's physician.
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. However, while the disease does subside quickly, it can recur, for
example at the s It is more common in boys, although occurs in girls as well. The average age of symptom onset is 9-11.