Sever disease refers to a calcaneal apophysitis (an inflammation of the apophysis of the heel) which occurs in children and young adolescents. It typically presents in active young children
(especially ones who engage in jumping and running sports).
Severs disease is often associated with a rapid growth spurt. As the bones get longer, the muscles and tendons become tighter as they cannot keep up with the bone growth. The point at which the
achilles tendon attaches to the heel becomes inflamed and the bone starts to crumble (a lot like osgood schlatters disease of the knee). Tight calf muscles may contribute as the range of motion at
the ankle is reduced resulting in more strain on the achilles tendon. Sever's disease is the second most common injury of this type which is known as an apophysitis.
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 heel pain usually increases. Heel pain can be felt in one or both
heels in Sever's disease.
Sever disease is most often diagnosed clinically, and radiographic evaluation is believed to be unnecessary by many physicians, but if a diagnosis of calcaneal apophysitis is made without obtaining
radiographs, a lesion requiring more aggressive treatment could be missed. Foot radiographs are usually normal and the radiologic identification of calcaneal apophysitis without the absence of
clinical information was not reliable.
Non Surgical Treatment
Activity Modification: to decrease the pain, limiting sporting activities is essential. Cutting back on the duration, intensity, and frequency can significantly improve symptoms. Heel cord stretching
is important if heel cord tightness is present. Heel cushions/cups or soft orthotics decreases the impact on the calcaneus by distributing and cushioning the weight bearing of the heel. Use of
NSAIDS. Ibuprofen (Nuprin, Motrin) or naproxen (Aleve) can decrease pain and secondary swelling. Ice. Placing cold or ice packs onto the painful heel can alleviate pain. Short-leg cast. For
recalcitrant symptoms a short-leg cast is occasionally used to force rest the heel.