Treatment and prevention
Sever’s disease is a common heel injury seen in children. Adequate rest and over-the-counter (OTC) pain medications may help relieve Sever’s disease pain faster. Sever’s disease usually goes away once the growth plate has matured. However, if the child is suffering from heel pain, follow conservative treatment options, such as
- Avoiding strenuous physical activities for a few weeks.
- Stretches and exercises to reduce tension on the growth plate.
- Temporary use of heel cushions, pads, or lifts.
- Wearing orthotics, especially in cases where structural problems with the feet are contributing to the condition.
- Stretches for the calf and Achilles tendon are especially helpful.
- Wrapping ice in a towel and propping the affected heel on top can reduce pain and inflammation as well.
- Gradually returning to activities is recommended, and corrective shoe inserts or heel lifts may be prescribed.
- Using an elastic wrap or compression stockings may help reduce the swelling and pain. Elevating the heel above the heart level also helps with the swelling.
- Over-the-counter (OTC) pain medications (such as acetaminophen or ibuprofen) may be taken to reduce the pain and swelling.
Children with Sever’s disease are at an advantage because
- Their soft tissue is very flexible and adapts quickly. The condition improves in 10 to 14 days in a child. For an adult, it takes 30 days to achieve.
- A child’s bones are soft and can be changed if held in a better position. Bad mechanics can be addressed in a child. There is a greater potential for change in the bone structure.
- If enough correction occurs in the early developmental years, many adult problems could be eliminated. For that reason, orthotic therapy might be a recommended course of treatment for this condition.
How to prevent Sever’s disease
In the most severe cases, the child may need to have their foot immobilized in a short cast or walker boot to protect the growth plate so that it can fully recover. However, this is rare. Surgery and laser therapy are used in rare situations. Sever’s disease can be prevented with the following recommendations:
- Wearing good quality, well-fitting shoes with a shock-absorbent sole to reduce pressure on the heel.
- Avoiding heavy or high-heeled shoes.
- Avoiding excessive running on hard surfaces.
- Maintaining a healthy weight.
- Stretching exercises and applying should be continued after sports activities to prevent the recurrence of Sever’s disease.
What is Sever’s disease?
Sever’s disease is an injury to a relatively soft section of the heel bone called the growth plate. This type of injury can produce mild to moderate pain and tenderness underneath the heel, along with mild swelling. A child with Sever’s disease may find it difficult or uncomfortable to play sports, be active, or spend much time walking or standing.
In more serious cases, significant pain and even limping may be observed.
Sever’s disease is an issue that develops due to differences in physical maturity between the calcaneus (heel bone) and the Achilles tendon (which connects to the back of the heel).
The growth plate located in the back of the heel can develop more quickly than the Achilles tendon. This results in the tendon and calf muscle becoming tight and pulling excessively (and painfully) on the growth plate.
This condition is commonly seen in girls aged 8 to 13 years and boys aged 10 to 15 years. However, it can sometimes happen a little earlier or later than those ranges.
Unfortunately, no one can say with 100% certainty why one child is affected and another is not. However, several risk factors correlate with greater risk.
- Being active: Sever’s disease is an overuse injury. Kids that play a ton of sports without much rest are more likely to develop it.
- Certain sports: Sports played on hard surfaces and those involving running and jumping come with the highest risk. Football, basketball, gymnastics, track, and certain types of dance, for example.
- Active growth spurt: Being in the middle of a growth spurt increases the risk that tendons and muscles will become tight and pull uncomfortably on the heel.
- Poor shoes: Athletic shoes and cleats that are too small, large, or flat (which do not provide adequate arch support) can magnify the force loads on the heel bone.
- Obesity: Sever’s disease is more commonly associated with highly active kids. However, children who are substantially overweight are also at elevated risk. A heavier child will naturally put more weight and force on their feet during any given activity than a lighter one.
Whether caused by Sever’s disease or another condition, persistent heel pain is never something to ignore at any age. Sever’s disease can be managed through strapping the heel with kinesiology tape (to reduce loading during sporting activities) and foot support devices, such as heel lifts.
Also, in-shoe wedging and orthotics to improve foot function and gait patterns have been shown to significantly reduce pain. Stretching and strengthening exercises, along with appropriate footwear modification, will also help alleviate the condition.
Boston Children's Hospital. Sever’s Disease. https://www.childrenshospital.org/conditions-and-treatments/conditions/s/severs-disease
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