Children who experience a lot of pain in their heels may be suffering from Sever’s disease, due to an injury on the heel’s growth plate. It is not all that uncommon and can be treated through a variety of means, says Dr. Adam Teichman, owner and founder of East Penn Foot & Ankle Associates in Allentown, Easton and Reading, Pennsylvania.
Sever’s disease is characterized by heel pain in children. It is usually associated with pediatric heel pain, and is also known Calcaneal Apophysitis. It commonly occurs when boys and girls hit puberty, although it is more common in boys.
Sever’s disease occurs due to an injury of the growth plate in the heel. A growth plate is an area of growing tissue in the bone that determines the length of the bone. Injuries of the heel are usually caused by overuse in that area, which is why Sever’s disease often strikes when a child tries a new sport, for example.
Symptoms of Sever’s Disease
Symptoms of Sever’s disease are pain in the back or bottom of the heel, limping, walking on toes, and difficulty participating in normal activities or sports. Sever’s disease usually occurs in ages 8 to 14 years, as mentioned around the time of puberty, because the bones in the body are growing faster than the tendons at this time.
This means that the heel core, which is near the Achilles tendon, is relatively short compared to the leg bone, causing this tendon to fall on the growth plate of the heel. This causes more tension on the heel bone, causing irritation and pain. Pediatric heel pain usually does not improve with activity; in fact, it makes it worse.
Diagnosis and Treatment
The diagnosis usually is a through medical history, and examining the child’s foot and leg. In many cases, x-rays are often used. Sometimes an MRI or a CT scan can be helpful in diagnosing Sever’s disease.
The treatment again is RICE, which stands for Rest, Ice, Compression and Elevation. Patients should also make sure that they cushion the heel, and medications such as non-steroidals can be used. Physical therapy and custom-made foot orthotic devices can also be used.
As a last resort, if it does not get better, sometimes lengthening the tendon through surgery can be implemented, but usually not until other methods have tried and failed. Stretching exercises are also recommended.
The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.
