Sever's disease is an overuse syndrome involving an immature part of the skeleton. Pain goes away when the overuse is over, or when the growing is done. Hence, the disease is self-limited, in that the pain goes away eventually when growth in the heel bone is complete at about age 13. Even if the child is hurting, as long as he can tolerate it, he may continue to take part in sports. No long term disability is expected from this problem.
Sever?s disease is caused by repetitive tension and/or pressure on the growth center of the heel. Running and jumping place a large amount of pressure on the heels and can cause pain. Children with Sever?s may limp or have an altered gait due to the pain. Risk factors for Sever's include tight calf muscles, weak ankle muscles, and alignment abnormalities at the foot and ankle. Sever?s can also result from wearing shoes without sufficient heel padding or arch support.
Adolescents suffering from Sever?s disease usually complain of pain at the back of their heel which is often worse after exercising. It is most common between the ages of 10-12 in boys and 8-10 in girls due to the rapid growth spurts that occur during this time. It can however happen anytime up until the age of 15. Whilst most people present with pain worse in one foot, it is very common to have symptoms in both feet.
A doctor can usually tell that a child has Sever's disease based on the symptoms reported. To confirm the diagnosis, the doctor will probably examine the heels and ask about the child's activity level and participation in sports. The doctor might also use the squeeze test, squeezing the back part of the heel from both sides at the same time to see if doing so causes pain. The doctor might also ask the child to stand on tiptoes to see if that position causes pain. Although imaging tests such as X-rays generally are not that helpful in diagnosing Sever's disease, some doctors order them to rule out other problems, such as fractures. Sever's disease cannot be seen on an X-ray.
Non Surgical Treatment
First, your child should cut down or stop any activity that causes heel pain. Apply ice to the injured heel for 20 minutes 3 times a day. If your child has a high arch, flat feet or bowed legs, your doctor may recommend orthotics, arch supports or heel cups. Your child should never go barefoot. If your child has severe heel pain, medicines such as acetaminophen (one brand name: Tylenol) or ibuprofen (some brand names. Advil, Motrin, Nuprin) may help.
It may take several weeks or months for the pain to completely stop. When the pain is completely gone, your child may slowly return to his or her previous level of activity.