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Sever's Disease
Sever's Disease
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What is Sever's Disease?
Sever's disease is a common cause of heel pain in active children. It
occurs when the growth plate of the heel is injured by excessive forces
during early adolescence.
Why Does Heel Pain Occur in Some Children and Not Others?
During puberty, children's bones are also growing. This creates a relatively soft section within the bones commonly known as growth plates.
This may not be a problem unless your child participates in sports that
involve running and jumping activities. These activities place
excessive stresses upon the relatively soft heel growth plate, which
causes their heel pain.
Add to this the fact that your child's bones lengthen faster than their associated muscles and tendons. This results in their muscles and tendons become comparatively tighter as the bone lengthens, which places further tension on the soft growth plate.
Ultimately, your child complains of heel pain and will limp when they run or walk.
When is Your Child at Risk of Sever's Disease?
Your child is most at risk for this condition during the early phases of puberty. Sever's disease is most common in athletic children. Peak incidences are:
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Girls: 8 to 10 years old.
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Boys: 10 to 12 years old.
Which Sports Cause Sever's Disease?
Children who do any running or jumping activity may be affected. In particular, football players, cross country runners, netballers and gymnasts often suffer Sever's disease.
Sever's disease rarely occurs beyond the age of 15 as their heel growth plate has finished growing.
Is Your Child Suffering Sever's Disease?
Heel pain can be felt in one or both heels in Sever's disease sufferers. A recent increase in their running or jumping activities can predispose them to the injury.
Clinically, your physiotherapist will perform a "squeeze test" to confirm the diagnosis.
As a parent, you may notice your child limping while walking or running awkwardly. If you ask them to rise onto their tip toes, their pain usually increases.
What's the Treatment for Sever's Disease?
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"No Pain. No Gain" does not apply in Sever's disease.
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Your child should reduce or cease any activity that causes heel pain.
- Ice packs should be applied to their heel for 20 to 30 minutes once or twice a day until the symptoms settle.
- Professional assessment is highly recommended.
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Prediposing Factors for Sever's Disease
It's not only the condition that requires attention. It is also predisposing factors such as:
- Muscle length imbalances
- Muscle weakness
- Poor propriocepetion or balance
- Poor foot biomechanics
- Inappropriate training regimes
- Inappropriate footwear
Your physiotherapist or podiatrist will also assess what is predisposing your child to Sever's disease and start addressing those issues straight away.
What about Orthotics?
Your physiotherapist or podiatrist can assess your child's arch.
Occasionally, an orthotic may need to be prescribed for temporary or long-term correction of their foot biomechanics (eg flat feet or high arches).
During the acute phase of Sever's disease a small heel rise or shock-absorbing heel cup placed under the heel pad of your child's foot may help to ease their symptoms.
We recommend that your child should never go barefooted during the painful stages of Sever's disease.
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PhysioWorks or Book Online
Will Strengthening Exercises Help?
You child may benefit from arch control exercises. These exercises can correct foot problems such as flat feet and will have long-term benefits to both your child's health and their sporting performance.
Your PhysioWorks physiotherapist has unique training in the dynamic retraining of your child's arch muscles.
Will Your Child need to Avoid Playing Sport?
We recommend active rest.
That is, your child's sport should be reduced to avoid any pain. If your child has pain at rest, they should not participate in any sport. If your child has pain walking, they should avoid walking or running. Crutches for a few weeks may be advisable in severe cases.
For the best advice, please consult your physiotherapist or podiatrist, who can guide you based on your child's symptoms. In most cases and under professional guidance, your child should feel better within a few weeks and allow them to safely return to sport.
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PhysioWorks or Book Online
What Are The Long-Term Consequences Of Sever's Disease?
Poorly treated Sever's disease can result in a permanent bone deformity (lump) at the rear of the heel bone (calcaneum). Long-term this can cause shoe-fitting difficulties and blisters.
Less obvious long-term effects can include foot arch problems (leading to plantar fasciitis or heel spurs), ankle joint misalignment (predisposing to future ankle sprains), and tight calf musculature leading to Achilles tendinopathy.
How Can You Prevent Sever's Disease?
Sever's disease may be prevented by maintaining good muscle flexibility in the years leading up to, and during, their growth spurts (eg girls 8 to 10, boys 10 to 12).
Arch problems such as flat feet should be addressed after the age of 5 if they don't appear to be self-correcting. If you are concerned, please ask your physiotherapist or podiatrist.
Good-quality sports shoes with a foam arch support; firm heel cup and 3/4 or full board-last should support your child's foot sufficiently. The most important factor is the amount of exercises your child is currently performing.
LISTEN To Your Child!
If your child is suffering heel pain between the ages of 8 to 12, suspect Sever's disease and seek professional opinion regarding its diagnosis and management.
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PhysioWorks or Book Online
FAQs about Sever's Disease
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Helpful Products for Sever's Disease
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