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Sever's Disease

If your child has started to develop heel pain following a growth spurt, they could potentially have Sever's Disease, especially if they're very active. Read on for a  basic overview of what this means, and what can be done about it.

What is Sever's Disease?

?Sever's Disease, also known as calcaneal apophysitis, is an inflammatory condition that involves pain in one or both heels. It is typically present in younger children and adolescents, particularly around periods of rapid growth. This condition has a similar mechanism of injury as Osgood Schlatter Syndrome, where there may be a discrepancy between the rate of bone growth and muscle length, especially during puberty. Males are twice as likely to develope Sever's when compared to females, generally between the ages of 7-15 for boys and 5-13 for girls. Symptoms will most commonly appear at the start of a sporting season, following a growth spurt from the child.

As the tibia and fibula grow rapidly, there can be an increase in the tension of the calf muscles. This typically results in more force being transferred through the Achilles tendon, and down into the Calcaneus (heel bone). As adolescents are still growing, their growth plates in their bones haven't hardened, and therefore are sensitive to large amounts of force. The combination of these factors can result in irritation and inflammation in growth plate in the heel, leading to pain and discomfort. High impact sports that involve a lot of running, jumping, and change of direction can exacerbate this pain, as the forces involved tend to place further stress on the Achilles tendon and the calcaneus. 


What are the symptoms?

The primary symptom with Sever's will be pain at the base of the heel. The individual will generally have a reduced ankle range of motion, particularly with dorsiflexion (moving the foot towards the shin). This pain will worsen with increased activity, typically involving running, jumping, and landing. Itis likely that by the end of a the child's sporting session they will have a significant limp. This increase in soreness can sometimes carry across to the follow day, and the heel will still be sore to walk on the next morning. 


What treatment is available, and how long is recovery?

There is a fairly large range in recovery time, and this can be influenced by mutliple factors. The timeline for Sever's disease usually ranges between a few weeks to a few months. Things such as the severity of the inflammation/pain, the amount of growth that has occured recently, whether it affects one or both heels, and the sporting demends of the individual all can play a role in how long the condition persists for. Generally the quicker that treatment is seeked, the quicker the condition can be resolved.

If you want to reduce your recovery time and keep playing/get back to playing sport sooner, that's where physiotherapy can make a big difference. Performing the correct strength exercises and/or stretches can help reduce the tension through the calves, and hence reduce the amount of force at heel. Modifying other factors such a the type of shoes being worn, if any inserts or orthotics are being worn, surfaces which sport are being played on, and potentially taping during sport can all make a difference to amount of pain experienced.

Looking at managing the overall volume of sport/exercise is also an important factor to consider, and this too can be discussed with your Physiotherapist. Working together, a plan can be formulated to allow the continuation of sport in some capacity while avoiding aggravating the heel too much.

Please contact us or book online if you want to find out more about this condition, or any other concerns that you may have.
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