INTRODUCTION​

• Sever’s Disease, also known as calcaneal apophysitis, is a common condition affecting growing children and adolescents

• It is characterized by inflammation of the heel bone growth plate

• This condition is often associated with growth spurts  

• 100% of Sever’s disease cases resolve by the time of skeletal maturity

CAUSES 

• Sever’s disease is caused by repetitive overload of the achilles tendon on the heel bone growth plate

• Growth plates are weaker than tendons and ligaments and are more vulnerable to injury

• Common in active adolescents participating in jumping sports, but can occur in any growing child

SIGNS AND SYMPTOMS

• Pain and occasional swelling in the back of the heel over the achilles tendon and the heel bone

• Tenderness of the heel bone

• Pain is usually worse after activity but can also be present at rest

TREATMENT​​

• Treatment of Sever’s disease is centered around a home exercise program focused on eccentric strengthening and stretching of the achilles tendon

• Anti-inflammatories such as ibuprofen are oftentimes helpful as an adjunct to other treatments

• Heel sleeves and heel pads can decrease pain and swelling

• Heel lifts help offload the achilles tendon

• In refractory cases, a course of leg casting may be indicated

• There is no role for surgery in Sever’s disease

PREVENTION  ​​

• The best way to prevent this condition is to avoid repetitive activities that overload the achilles tendon

• Avoid wearing flat shoes in growing children as this may place excessive tension on the achilles and heel bone growth plate