Also known as or related to calcaneal apophysitis, heel pain, back of heel pain, kids heel pain
The large heel bone (called the calcaneus) has a growth plate at the back of the heel. This growth plate is made of soft cartilage and it gradually narrows and starts to turn into solid bone around 8 to 13 years of age. This growth plate is prone to becoming inflamed and painful at this time. The strong Achilles tendon happens to join onto the back of the heel bone and pulls on this growth plate when running causing Sever’s disease.
Children aged between 8 to 13 years of age can experience Sever's disease with girls being normally younger and boys slightly older. Sever’s disease normally involves the back of the heel bone becoming painful towards the end of intense or prolonged activity and can remain painful after the activity for a few hours. Severe cases can result in limping and pain that can even remain the next morning after sport.
The more active a child is then the greater the chance of suffering from Sever’s disease. Poor foot function such as flat feet causes the calf and Achilles to work harder and pull on the growth plate leading to Sever’s disease. Tight calves or Achilles is common in growing children and can increase tension on the growth plate.
Traditional treatment involved simply telling children that they can’t play sport for a year. This is not popular for children or parents and abstaining from sport leads to other problems when wanting to return. Treatments focus on improving foot and lower limb function with footwear selection, heel raises, calf stretching, prescription orthoses, run technique training and training modifications. This results in a reduced load through the growth plate and the child can perform more activity before the growth plate becomes inflamed. Rest will always reduce the Sever’s disease symptoms, however this is always the last option.