Health Education

Sever’s Disease

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What is Sever’s Disease?

Sever’s disease occurs in children when the growing part of the heel is injured. This growing part is called the growth plate. The foot is one of the first body parts to grow to full size. This usually occurs in early puberty. During this time, bones often grow faster than muscles and tendons. As a result, muscles and tendons become “tight.” The heel area is less flexible. During weight-bearing activity (activity performed while standing), the tight heel tendons may put too much pressure at the back of the heel (where the Achilles tendon attaches). This may injure the heel.

When is a child most at risk for Sever’s Disease?

A child is most at risk for this condition when he or she is in the early part of the growth spurt in early puberty. Sever’s disease is most common in physically active girls eight to ten years old and in physically active boys ten to twelve years old. Soccer players and gymnasts often get Sever’s disease, but children who do any running or jumping activity may be affected. Sever’s disease rarely occurs in older teenagers, because the back of the heel has finished growing by the age of fifteen.

How do I know if my child’s heel pain is caused by Sever’s disease?

In Sever’s disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or she stands on tiptoe. Your child’s heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your provider may also find that your child’s heel tendons have become tight.

How is Sever’s disease treated?

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.

When can my child play sports again?

With proper care, your child should feel better within two weeks to two months. Your child can start playing sports again only when the heel pain is gone.

Are there any problems linked with Sever’s disease?

No long-term problems have been linked with Sever’s disease. However, call your provider if your child’s heel pain does not get better or if it gets worse, or if you notice changes in skin color or swelling.

Can Sever’s disease be prevented?

Sever’s disease may be prevented by maintaining good flexibility while your child is growing. The stretching exercises mentioned here can lower your child’s risk for injuries during the growth spurt. Good-quality shoes with firm support and a shock-absorbent sole will help. Your child should avoid excessive running on hard surfaces. If your child has already recovered from Sever’s disease, stretching and putting ice on the heel after activity will help keep your child from getting this condition again.