How is Sever's Disease in Children Treated?

Sever's disease, also known as calcaneal apophysitis, is a common condition that affects the growth plate at the back of the heel bone in children and adolescents. It is assumed to occur during occurs during periods of rapid growth and physical activity, often between the ages of 8 and 15. The classic symptom is pain at the back of the heel that is worse if you squeeze it at the sides of the heel bone. As the adolescent reaches the mid-teenage years the growth area at the back of the heel bone merges with the rest if the heel bone and it is no longer possible to have Severs disease after that time. They will always grow out it, but as it is painful and can be distressing for the child and parents, so it does need to be treated.

The main goal of treatment for Sever's disease is to relieve pain and inflammation while allowing the child to continue with their normal activities. It can often be a case of managing the symptoms until they grow out of it in the mid-teenage years. The mainstay of managing Sever’s diseases is rest. That is not total rest but is about reducing or temporarily avoiding activities that exacerbate the pain is important. This may include sports, running, or other high-impact activities. Rest allows the inflamed tissue in the heel to heal. Applying ice to the affected area after activity can help reduce inflammation and relieve pain. Stretching exercises for the calf muscles and Achilles tendon can be helpful to relieve tension on the heel's growth plate. These stretches should be done regularly and under the guidance of a healthcare professional or physical therapist. The child should wear well-fitting, supportive shoes with good arch support and cushioning. Avoid shoes with flat soles or inadequate support and have no cushioning. In some cases, foot orthotic inserts may be recommended to provide additional support and cushioning for the heel. Cushioning heel cups or lifts are often helpful. These are inserts that can be placed inside the shoe to help reduce strain on the Achilles tendon and growth plate. Over-the-counter pain relievers like ibuprofen or naproxen may need to be used if the pain gets very painful. A physical therapist can provide guidance on appropriate exercises, stretches, and techniques to manage pain and promote healing.

The main part of the rehabilitation of Sever’s disease is activity modification and managing the loads. Adjusting the level of physical activity and ensuring that your child does not overexert themselves can help prevent further irritation to the growth plate. This will often need to be done periodically if symptoms appear again. They can also help determine if any underlying factors or biomechanical issues need to be addressed to prevent recurrence. Also encourage the child to maintain a healthy lifestyle, including a balanced diet and adequate rest, to support overall growth and development. Sever’s disease is not difficult to treat and mostly involves understanding the nature of the conditions and how it impacts the child and the management of the activity levels.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.