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 can injure the heel and cause Sever's disease.
When is my child most at risk for Sever's disease?
Your 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 8 years to 10 years of age and in physically active boys 10 years to 12 years of age. Soccer players and gymnasts often get Sever's disease, but children who do a running or jumping activity may also be at an increased risk. Sever's disease rarely occurs in older teenagers because the back of the heel has typically finished growing by 15 years of age.
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 runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that your child's heel tendons have become tight.
What is the treatment for Sever's Disease?
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.
What is the prevention of Sever's disease?
Sever's disease may be prevented by maintaining good flexibility while your child is growing. The stretching exercises pictured in the treatment section can lower your child's risk for injuries during the growth spurt. Talk with your doctor for more advice. 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 developing this condition again.