Treating Severs Disease
Overview
Pain in the heel of a child's foot, typically brought on by some form of injury or trauma, is sometimes Sever's Disease. The disease often mimics Achilles tendonitis, an inflammation of the tendon attached to the back of the heel. A tight Achilles tendon may contribute to Sever's Disease by pulling excessively on the growth plate of the heel bone. This condition is most common in younger children and is frequently seen in the active soccer, football or baseball player. Sport shoes with cleats are also known to aggravate the condition. Treatment includes calf muscle stretching exercises, heel cushions in the shoes, and/or anti-inflammatory medications. Consult your physician before taking any medications.
Causes
Sever?s disease is common, and typically occurs during a child?s growth spurt, which can occur between the ages of 10 and 15 in boys and between the ages of 8 and 13 in girls. Feet tend to grow more quickly than other parts of the body, and in most kids the heel has finished growing by the age of 15. Being active in sports or participating in an activity that requires standing for long periods can increase the risk of developing Sever?s disease. In some cases, Sever?s disease first becomes apparent after a child begins a new sport, or when a new sports season starts. Sports that are commonly associated with Sever?s disease include track, basketball, soccer, and gymnastics. Children who are overweight or obese are also at a greater risk of developing this condition. Certain foot problems can also increase the risk, including. Over pronating. Kids who over pronate (roll the foot inward) when walking may develop Sever?s disease. Flat foot or high arch. An arch that is too high or too low can put more stress on the foot and the heel, and increase the risk of Sever?s disease. Short leg. Children who have one leg that is shorter than the other may experience Sever?s disease in the foot of the shorter leg because that foot is under more stress when walking.
Symptoms
Patients with Severs disease typically experience pain that develops gradually in the back of the heel or Achilles region. In less severe cases, patients may only experience an ache or stiffness in the heel that increases with rest (especially at night or first thing in the morning). This typically occurs following activities which require strong or repetitive contraction of the calf muscles, such as running (especially uphill) or during sports involving running, jumping or hopping. The pain associated with this condition may also warm up with activity in the initial stages of the condition. As the condition progresses, patients may experience symptoms that increase during activity and affect performance. Pain may also increase when performing a calf stretch or heel raise (i.e. rising up onto tip toes). In severe cases, patients may walk with a limp, have difficulty putting their heel down, or be unable to weight bear on the affected leg. Pain may also increase on firmly touching the affected region and occasionally a bony lump may be palpable or visible at the back of the heel. This condition typically presents gradually overtime and can affect either one or both lower limbs.
Diagnosis
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
The primary method of treating Sever?s disease is taking time off from sports and other physical activities to alleviate the pressure on the heel bone. During the healing period, your child?s doctor may also recommend physical therapy or any type of exercise that involves stretching and strengthen leg muscles and tendons. Wrapping ice in a towel and placing it under the child?s heel will also help to alleviate and reduce pain and swelling.
Pain in the heel of a child's foot, typically brought on by some form of injury or trauma, is sometimes Sever's Disease. The disease often mimics Achilles tendonitis, an inflammation of the tendon attached to the back of the heel. A tight Achilles tendon may contribute to Sever's Disease by pulling excessively on the growth plate of the heel bone. This condition is most common in younger children and is frequently seen in the active soccer, football or baseball player. Sport shoes with cleats are also known to aggravate the condition. Treatment includes calf muscle stretching exercises, heel cushions in the shoes, and/or anti-inflammatory medications. Consult your physician before taking any medications.
Causes
Sever?s disease is common, and typically occurs during a child?s growth spurt, which can occur between the ages of 10 and 15 in boys and between the ages of 8 and 13 in girls. Feet tend to grow more quickly than other parts of the body, and in most kids the heel has finished growing by the age of 15. Being active in sports or participating in an activity that requires standing for long periods can increase the risk of developing Sever?s disease. In some cases, Sever?s disease first becomes apparent after a child begins a new sport, or when a new sports season starts. Sports that are commonly associated with Sever?s disease include track, basketball, soccer, and gymnastics. Children who are overweight or obese are also at a greater risk of developing this condition. Certain foot problems can also increase the risk, including. Over pronating. Kids who over pronate (roll the foot inward) when walking may develop Sever?s disease. Flat foot or high arch. An arch that is too high or too low can put more stress on the foot and the heel, and increase the risk of Sever?s disease. Short leg. Children who have one leg that is shorter than the other may experience Sever?s disease in the foot of the shorter leg because that foot is under more stress when walking.
Symptoms
Patients with Severs disease typically experience pain that develops gradually in the back of the heel or Achilles region. In less severe cases, patients may only experience an ache or stiffness in the heel that increases with rest (especially at night or first thing in the morning). This typically occurs following activities which require strong or repetitive contraction of the calf muscles, such as running (especially uphill) or during sports involving running, jumping or hopping. The pain associated with this condition may also warm up with activity in the initial stages of the condition. As the condition progresses, patients may experience symptoms that increase during activity and affect performance. Pain may also increase when performing a calf stretch or heel raise (i.e. rising up onto tip toes). In severe cases, patients may walk with a limp, have difficulty putting their heel down, or be unable to weight bear on the affected leg. Pain may also increase on firmly touching the affected region and occasionally a bony lump may be palpable or visible at the back of the heel. This condition typically presents gradually overtime and can affect either one or both lower limbs.
Diagnosis
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
The primary method of treating Sever?s disease is taking time off from sports and other physical activities to alleviate the pressure on the heel bone. During the healing period, your child?s doctor may also recommend physical therapy or any type of exercise that involves stretching and strengthen leg muscles and tendons. Wrapping ice in a towel and placing it under the child?s heel will also help to alleviate and reduce pain and swelling.
