Severs, also known as calcaneal apophysitis, is a common cause of heel pain in growing children, typically between the ages of 8 and 14. It occurs due to inflammation of the growth plate in the heel, which is the area at the back of the heel where the Achilles tendon attaches to the bone.
Causes of Severs:
Growth Spurts: The condition often coincides with periods of rapid growth when bones, muscles, and tendons are growing quickly but at different rates.
Overuse: Activities that involve a lot of running, jumping, or other repetitive impact on the heel, such as soccer, basketball, or gymnastics, can contribute to the development of Sever’s disease.
Improper Footwear: Wearing shoes that do not provide adequate support can exacerbate the condition.
Foot Structure: Children with flat feet, high arches, or other foot abnormalities may be more prone to Sever’s disease.
Symptoms:
Heel Pain: The primary symptom is pain in the back or bottom of the heel, particularly after physical activity.
Tenderness and Swelling: The heel may be tender to the touch, and there can be some swelling.
Difficulty Walking: The child may walk with a limp or avoid putting pressure on the affected heel.
Diagnosis:
Physical Examination: A doctor will typically diagnose Sever’s disease through a physical exam, checking for tenderness and pain in the heel.
X-rays: Although not always necessary, X-rays may be taken to rule out other causes of heel pain.
Treatment:
Rest: Reducing or temporarily stopping activities that cause heel pain is essential.
Ice Applying ice to the affected area can help reduce pain and inflammation.
Heel Pads or Orthotics: These can provide extra cushioning and support.
Stretching Exercises: Stretching the Achilles tendon and calf muscles can help relieve tension on the heel.
Pain Relief: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain. Physical Therapy: In some cases, physical therapy may be recommended to strengthen and stretch the affected area.
Prognosis:
Sever’s is generally a self-limiting condition, meaning it usually resolves on its own as the child’s growth plate matures and hardens. With appropriate treatment, most children can return to normal activities without long-term issues. Some children may have a relapse of the symptoms. This can months to years after the initial onset, management is generally the same once the appropriate diagnosis is made.
Prevention:
Proper Footwear: Ensuring that children wear well-fitting shoes with good support can help prevent the condition.
Gradual Increase in Activity: Gradually increasing the intensity of physical activities can reduce the risk of overuse injuries.
Regular Stretching: Encouraging regular stretching of the Achilles tendon and calf muscles can help maintain flexibility and reduce strain on the heel.
