Sever’s Disease (Heels) Explained by Panama City Podiatrist

Unlike adults, heel pain is very uncommon in children.  When children do experience heel pain, it is highly likely to be caused by a disturbance to the growth plate in the backof the heel bone (calcaneus), where the Achilles tendon attaches to the heel. This disturbance is known as Sever’s disease or calcaneal apophysitis (inflammation of the growth plate). Sever’s disease is most common between the ages of 10 and 14 years, and it is one of several different ‘osteochondroses’ that may occur in other parts of the body, such as at the knee, such as Osgood-Schlatters Disease 

This condition occurs in children because they are still growing and their bodies harbor many “growth plates”.  A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite, which is how bones grow.

Physically active children run the risk of developing Sever’s disease because they put the most strain on their growing bones. Sever’s usually occurs during the adolescent growth spurt, when young people grow most rapidly. (This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys.) By age 15 the back of the heel usually finished growing.  As teens grow, the growth plates harden and the growing bones fuse together into mature bone.

Young people engaged in physical activities and sports that involve jumping and running on hard surfaces–such as track, basketball, soccer, and gymnastics—are ata higher risk for developing Sever’s disease.  Poor-fitting shoes can contribute  by not providing enough support or padding for the feet or by rubbing against the back of the heel (http://kidshealth.org/parent/medical/bones/severs_disease.html). 

Also, if you have a pronated foot (one that rolls in at the ankle when walking), a flat or high arch, which causes tightness and shortening of the Achilles tendon, one leg shorter than the other (short leg syndrome), or you are overweight, you are also at a higher risk for Sever’s disease.

Even if pain associated with Sever’s disease promises to elide over time through the normal maturation process of fusing bones, an article in Podiatry Today states there are still measures that can be taken to treat Sever’s disease, thus alleviating the pain associated with it

1.)   During an initial 2-3 week  period  I use physical therapy in combination with padding of strapping of the feet.

2.)  During the rest and recovery period, one can prescribe analgesics such as non-steroidal anti-inflammatory medications (NSAIDs) along with daily icing to the affected heel.

3.)  After the rest and recovery period, the “squeeze test” of the heel should be performed. If pain has elided, treatment should focus on increasing the strength and the biomechanical factors that contributed to Sever’s. At this time, patient can perform low-impact exercises such as the use of a stationary bike (at low resistance) and swimming.  They may use a treadmill if their heel is fitted with an appropriate orthoic life that protects strain in places that exacerbate the Sever’s disease.

4.)  During the next period— Orthotics with deep heel cups and a rearfoot posting for added motion control can be used.  

About the Author:  Dr. Burton S. Schuler foot doctor, foot specialist, podiatrist  of Panama City, Fl and the director of the Ambulatory Foot Clinics Podiatric Pain Management Center  and is a leading authority on the Morton’s Toe,  Long Second Toe and it associated problems. He is the author of the newly published book about The Morton’s Toe, Why You Really Hurt: It All Starts In the Foot. The book is published by the La Luz Press, Inc and is disturbed national by the Cardinal Publishing Group.  Why You Really Hurt: It All Starts In The Foot, is the story of how one bone in your foot could be the real reason for pains thru out your whole body. It is important because it offer the public new information about why millions of people suffer everyday with aches and pains, and offers new hope to get rid of problems they believed they would have to live with forever. It literally can be the “medical missing link”

  Dr. Schuler, graduated from the N. Y. College of Podiatric Medicine in 1975 at the age of twenty-four, and has been in private practice ever since. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty-five year professional career, he has written for Collier’s Encyclopedia and various podiatric journals and publications. He has been interviewed by The New York Times, First in Women, and other publications. Dr. Schuler has appeared on hundreds of radio and television programs both here and aboard. He is a Diplomate of the American Academy of Pain Management, and the National Board of Podiatric Examiners. Dr. Schuler is certified as a wound specialist from the American Boardof Wound Management. His professional and civic accomplishments have earned his inclusion in the 1999-2002 Who’s Who in America (Marquis).