What is Sever’s disease?

Most people have never heard of Sever’s disease until they experience it, or know someone who has it. Named after the physician who first described it in 1912, Sever’s disease is actually very common. It’s one of the most prevalent reasons children under 14 experience heel pain — particularly very athletic children — which is why the disease often falls into the “sports injury” and “sports podiatry” categories.

How is Sever’s disease caused?

Your heel has a growth plate, which is a layer of cartilage near the end of the bone. Sever's disease is a swelling and irritation of that growth plate. During physical growth and development in young teenagers, this plate is weaker and more at risk for injury than the rest of the bone.

Sever’s disease is sometimes mistaken by well-intentioned parents — and even GPs — as “growing pains”. Although muscles, tendons, bones and cartilage grow quickly during a growth spurt and can cause discomfort, the condition is notably more painful.

Who is most likely to develop Sever’s disease?

Children and adolescents from age eight to 14 most commonly have Sever’s disease. Very active children are more at risk, and boys are more likely to develop the condition than girls. Additionally, you might want to keep an eye on your child’s foot health if they:

• Frequently run and jump, especially on hard surfaces.

• Participate in high-impact sports, such as gymnastics, volleyball, and basketball.

• Are overweight.

• Wear shoes with inadequate foot and ankle support.

• Wear shoes that are inappropriate for their sports activities.

As children grow into adolescents and adults, the growth plate we mentioned before becomes solid bone, and the heel and tendons can withstand more force. This is why Sever’s disease doesn’t affect adults.

What are the symptoms of Sever’s disease?

The most common complaint is pain in the back of the heel, however, symptoms can also be similar to those of plantar fasciitis or shin splints. These conditions aren’t related, which is why it’s important to take your child to a podiatrist with knowledge of sports podiatry so they can be correctly diagnosed.

Here’s what you should watch for:

• Your child has pain in one heel or both heels (most children report pain in both). This pain worsens after physical activities but seems to improve with rest.

• You notice redness, swelling and irritation in the heels.

• Your child walks on their toes or with a limp.

• Your child is reluctant to play or climb.

• Your child is reluctant to partake in their usual sports activities.

Diagnosing Sever’s disease.

Sever’s disease can last for years, until the bone fully forms — another important reason for a proper diagnosis and management. However, although Sever’s disease can be painful during the developmental years, it doesn’t cause long-term damage and will often resolve itself once your child reaches adulthood.

Nevertheless, only a podiatrist can support your child with proper treatment and help with pain management. The team at The Perth Podiatrists can diagnose Sever’s disease with a physical exam. This involves applying gentle pressure to the heel, analysing any signs of redness or swelling, and asking your child some simple questions about their pain. We might also run an MRI or X-ray to rule out other possibilities, such as a fracture.

Treating Sever’s disease.

Treating Sever’s disease is quite straightforward, if not a little inconvenient. Recovering from Sever’s disease often takes time and patience; it might take a few months before the condition completely goes away.

Rest.

On the personalised advice of your podiatrist, your child will need to take a break from vigorous activities (such as sport) for several days or weeks. Sometimes, even an entire season off is required. When the rest period is over, encourage your child to take it slow and ease into their usual activities to prevent the pain from returning.

Your child can still stay active and enjoy fitness with low-intensity activities such as swimming.

Ice & pain relievers.

Ice packs can be applied to the heel a few times a day for four or five days (or however long your podiatrist recommends). If sporting activities can’t be avoided for some reason, ice packs should be used before and after the activity, and during breaks if the sport has them.

Over-the-counter anti-inflammatory drugs can also relieve pain and swelling.

Stretching exercises.

After your diagnosis, your sports podiatrist is likely to show you some simple physical therapy exercises. Sticking to the exercises and stretching schedule provided to you will strengthen the heels, Achilles tendons, calves and hamstrings. This makes the muscles better able to support the feet and heels, which reduces strain and pressure on the growth plate.

Supportive shoes.

Your child must wear shoes that fit properly and correctly support the arches. They might also need some kind of insert to provide more support. For example, cushioned heel pads help absorb shock and decrease the pressure on your child’s heels.

Casts & splits.

If your child still has heel pain after a few weeks of rest, your podiatrist may recommend immobilisation using a cast or splint. This will protect the growth plate even more and give it time to heal.

Sever’s disease care at The Perth Podiatrists.

The Perth Podiatrists can help you monitor, manage, and regulate the concerns that come with Sever’s disease. Our Podiatrists are very knowledgeable about this condition and can provide a timely diagnosis with a tailored treatment plan. Our goal is to help your child get back to their usual activities as soon as possible!

Based in WA, we have accessible clinics in Duncraig and Woodlands. It’s easy to book your appointment online. We hope to see you soon.