What is Sever’s Disease?
Sever’s Disease Information
Sever’s Disease or Sever’s Lesion, otherwise known as calcaneal apophysitis, is a traction apophysitis of the insertion of the Achilles tendon to the calcaneus (heel bone).
This condition is the painful inflammation of the heel bone caused by repetitive microtrauma.
It is a common heel injury that typically occurs between the ages 8 and 14 years. It is most commonly seen in physically active children who are involved in sports involving running and jumping.
This is the second most common osteochondrosis seen in young athletes after Osgood-Schlatter lesion.
It is often present at a time of rapid growth where muscles and tendons become tighter as the bones become longer.
Sever’s Disease Symptoms
The condition is characterised by inflammation and pain in the growth plate of the heel (the calcaneal apophysis), where the Achilles tendon attaches to the heel bone. This area is still developing in children, and repetitive stress and tension on the growth plate can lead to irritation and inflammation.
The main symptoms of Sever's disease include: heel pain, especially during or after physical activity, and difficulty walking or participating in sports. The pain tends to worsen with running or jumping activities.
Sever’s Disease Presentation
Heel pain during high-level physical activities most commonly in sports involving running and jumping, such as basketball, football or gymnastics.
Localized tenderness and swelling at the insertion of the Achilles tendon.
May have a limp after physical activity.
Muscle tightness of the calf muscles (gastrocnemius and soleus)
Reduced ankle range
Biomechanical findings may be present.
Sever’s Disease Treatment
Treatment for Sever's disease typically involves:
Rest: Reduced or modified activity levels to allow the affected tissues to heal.
Ice: Applying ice to the affected heel can help reduce inflammation. Ice can be applied for 15-20 minutes at a time, several times a day.
Muscle release: calf muscle
Sever’s Disease exercises: Gentle stretching exercises for the calf muscles may help alleviate tension on the growth plate.
Activity and load management: There is no need to rest completely. Pain is the main guide as to the limitation of activity.
Supportive footwear: Wearing shoes with good arch support and cushioning can help reduce strain on the heel.
Orthotic inserts: Orthotics or heel raising inserts may be prescribed to provide additional support and cushioning.
Over-the-counter pain medication: Non-prescription pain relievers, such as ibuprofen, may be recommended to manage pain and inflammation.
Biomechanics correction strategies.
Prognosis:
The condition usually settles within 6 to 12 months but occasionally symptoms will persist for as long as two years.
It's important to consult with a healthcare professional, such as a physiotherapist, for an accurate diagnosis and appropriate treatment plan for Sever's disease. If left untreated, the condition generally resolves on its own once the growth plate has finished developing but will often remain symptomatic during growth periods, becoming increasingly symptomatic with increased activity participation.