Sever?s disease or Sever?s lesion refers to an injury to the bone growth plate at the back of the heel bone (calcaneous) in young people, particularly those who are physically active. It usually
develops in puberty and is slightly more common in boys than girls.
The usual cause is directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves a lot of heel movement. It can be associated with
starting a new sport, or the start of a new season, or too much weight bearing on the heel. Also, excessive traction could cause this, since the bones and tendons are still developing. Many children
who over pronate their feet exhibit symptoms and in most patients, it usually involves both heels.
Athletes with Sever?s disease are typically aged 9 to 13 years and participate in running or jumping sports such as soccer, football, basketball, baseball, and gymnastics. The typical complaint is
heel pain that develops slowly and occurs with activity. The pain is usually described like a bruise. There is rarely swelling or visible bruising. The pain is usually worse with running in cleats or
shoes that have limited heel lift, cushion, and arch support. The pain usually goes away with rest and rarely occurs with low-impact sports such as bicycling, skating, or swimming.
Your podiatrist will take a comprehensive medical history and perform a physical examination including a gait analysis. The assessment will include foot posture assessment, joint flexibility (or
range of motion), biomechanical assessment of the foot, ankle and leg, foot and leg muscle strength testing, footwear assessment, school shoes and athletic footwear, gait analysis, to look for
abnormalities in the way the feet move during gait, Pain provocation tests eg calcaneal squeeze test. X-rays are not usually required to diagnose Sever?s disease.
Non Surgical Treatment
First, your child should cut down or stop any activity that causes heel pain. Apply ice to the injured heel for 25 minutes three times a day. Your child should not go barefoot. If your child has
severe heel pain, ibuprofen (Advil) will help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should
do these stretches five times each, two or three times a day. Each stretch should be held for 20 seconds. Your child also needs to do exercises to strengthen the muscles on the front of the shin. To
do this, have your child stand facing a wall to stretch the calves and the heel cord. Place one foot a shoulder?s width in front of the other, both feet facing the wall. The front knee is bent and
the back knee is straight during the calf stretch. Then have your child push against the wall and feel the stretch in his or her back leg. To stretch out the heel cord, have him or her stay in the
same position and bend the back knee. Repeat three times. Practice this stretch twice daily.
To prevent recurrence, patients, parents, coaches, and trainers should be instructed regarding a good preexercise stretching program for the child. Early in the season, encouragement should be given
for a preseason conditioning and stretching program. Coaches and trainers should be educated about recognition of the clinical symptoms so they are able to initiate early protective measures and seek
medical referral when necessary.