Pain in the heel of a child's foot, typically brought on by some form of injury or trauma, is sometimes Sever's Disease. The disease often mimics Achilles tendonitis, an inflammation of the tendon
attached to the back of the heel. A tight Achilles tendon may contribute to Sever's Disease by pulling excessively on the growth plate of the heel bone. This condition is most common in younger
children and is frequently seen in the active soccer, football or baseball player. Sport shoes with cleats are also known to aggravate the condition. Treatment includes calf muscle stretching
exercises, heel cushions in the shoes, and/or anti-inflammatory medications. Consult your physician before taking any medications.
Sever?s Disease is thought to be caused by several reasons. Growth spurts. The muscles and tendons become tight due to rapid bone growth. Overuse. Sever?s Disease can also occur in children who are
athletically active and overwork his or her muscles. Some physicians are beginning to caution parents about checking their children?s shoes to make sure they fit well and do not pinch or put undue
pressure on the child?s feet. Pronation can also bring on Sever?s Disease.
The pain associated with Sever's disease is usually felt along the back of the heel and becomes worse when running or walking. In some children, the pain is so severe they may limp when walking. One
of the diagnostic tests for Sever's disease is the "squeeze test". Squeezing both sides of the heel together will produce immediate discomfort. Many children feel pain immediately upon waking and may
have calf muscle stiffness in the morning.
Sever?s disease can be diagnosed based on the symptoms your child has. Your child?s doctor will conduct a physical examination by squeezing different parts of your child?s foot to see if they cause
any pain. An X-ray may be used to rule out other problems, such as a broken bone or fracture.
Non Surgical Treatment
The initial treatment is rest, relieve the pain and treat the underlying cause. The foot and ankle should be rested so that the apophysis it is not being continually ?injured?. A small heel
(sorbothane heel insert) raise can used to raise the heel and take the stretch off the Achilles tendon. It may be sufficient to stop your child playing sport but some children require a short period
of bed or couch rest. Some children find resting very difficult and require the use of braces or plasters or boots to slow them down. Using crutches is advised. Severs is usually caused by tight
muscles. A stretching program should be followed usually supervised by a physiotherapist. The stretching program may need to be undertaken up to 5 times a day. If flat feet are a problems orthotics
(insoles) should be used. The pain should be controlled by rest (limiting activity) and ice (icing the painful area 3-4 times a day - making sure the skin is not burnt), Simple pain killers can be
used such as paracetamol as well as anti-inflammatory tablets and cream. Severs disease usually goes away with time. When your child stops growing, the pain and swelling should go away because the
growing (weak) area fuses and becomes solid bone which is very strong.