Sever’s disease is an injury to the heel bone caused by traction of the Achilles tendon at its insertion site. This traction results in stress on the heel bone, causing inflammation and pain.
Sever’s occurs most commonly in very active and/or overweight adolescents from 8-15 years olds who are at a time of rapid growth1. A child’s bones can often grow more rapidly than their accompanying muscles and tendons, resulting in a stretching and consequent tensioning of the muscles and tendons on the elongated bone. Tension can also be caused by a tight calf muscle.
Sever’s disease is a self-limiting condition and will usually settle within 6-12 months.
Risk factors for developing Sever’s disease include:
– Participation in sports that involve running and jumping, especially if performed prior to skeletal maturity.
– Boys age: 7-15, Girls age: 5-13.
– Male gender
– Improper footwear
– Excessive heel pressure
– Poor foot biomechanics
The patient is likely to present with activity-related pain, such as pain when walking, running or playing sport.
Signs and symptoms include:
– Localized dull ache and tenderness at the back of the heel
– Pain exacerbated by climbing stairs and uphill running
– Tightness in calf muscle
– Toe walking
– Often affects both sides
Xray examination is not usually required.
Physiotherapy Treatment of Sever’s disease may include the following:
– Activity modification to a pain-free level. This may require cessation of sport.
– Heel raise in shoes or orthotics.
– Appropriate footwear prescription.
– Correction of biomechanical abnormalities.
– Strengthening and/or stretching exercise programs.
– Patient education.
– Heel taping.
– Anti inflammatories
– Application of ice
If your child is complaining of pain in his heel or his Achilles tendon, physiotherapy is advised.