Sports Medicine: Heel Pain/Sever’s Disease
What is Sever’s Disease?
Sever’s disease (calcaneal apophysitis) is the most common cause of heel pain in young and growing athletes. It is most common in athletes from 9-14 years of age that participate in running or jumping sports.
What causes Sever’s Disease?
Sever’s disease is pain resulting from inflammation of the growth plate of the calcaneal bone. The pain may be aggravated by repetitive micro-trauma to the tissues around the heel. Several factors that may contribute to Sever’s disease:
- Sport played on a hard surface (basketball, outdoor winter sports)
- Tight calf muscle
- Tight Achilles tendon
- Flat (pronated) foot
- Heavier children
- Footwear with poor support (cleats)
What are the symptoms of Sever’s Disease?
Pain at the back and/or bottom of the heel, which increases with activity, is the main symptom of Sever’s disease. The pain is relieved when the athlete is not active. The athlete may also feel discomfort when the heel is squeezed. Running or jumping make the symptoms worse.
How is Sever’s Disease diagnosed?
A physician will use a thorough history and a physical exam to diagnose Sever’s disease. The physician may also order x-rays to rule out other types of injuries that may mimic this condition.
What is the treatment for Sever’s Disease?
Treatment depends on the severity of the injury and can include the following:
- P.R.I.C.E. (protection, rest, ice, compression, elevation)
- Foot orthotics
- Calf stretching
- Anti-inflammatory medication
- Heel cup/wedge in the shoe to elevate the heel
- Limit activity
What is the long term outlook for Sever’s Disease?
Although Sever’s disease may last for years, with proper diagnosis and treatment for symptom relief, full return to activity is allowed. The condition is self-limiting and will resolve following the period of rapid growth in the region of the calcaneus. There are no long term risks, or adverse effects of the condition.