Pediatric Calcaneal Apophysitis (Sever’s Disease)
Calcaneal apophysitis (also called Sever’s disease) describes an inflammation (swelling) of the calcaneal apophysis (heel) growth plate, which causes heel pain.
Typically impacting young athletes, calcaneal apophysitis usually affects children between ages 8 and 14 years old, as the heel bone is not fully developed until age 14. The heel growth plate (area of growing tissue at the end of long bones) suffers damage due to repeated trauma. This is because the Achilles tendon (tendon that runs along the back of foot above the heel) pulls the apophysis during activities. It typically occurs in both heels, but can also occur in only one heel.
Calcaneal apophysitis can occur due to repeated trauma through the following:
- Abnormal growth patterns where the bones grow faster than the soft tissue (muscles or tendons), which pull on the growth plate
- Additional strain from abnormal weight gain or obesity
- Flat feet or a high arch in the foot
- Improperly fitted footwear or not enough support from shoes
- Repeated running and jumping as the feet pound on hard surfaces (can occur in athletes who play basketball, soccer or track)
- Tight lower leg muscles, specifically in the calf and Achilles tendon
Symptoms of calcaneal apophysitis can include:
- Heel pain during sports
- Heel pain on one or both sides
- Heel swelling
- Pain when the heel is squeezed