What is Sever's Disease?
Sever's disease, also known as calcaneal apophysitis, is a painful condition that affects the growth plate in the heel bone (calcaneus) of children and adolescents. It is a type of overuse injury that commonly occurs during periods of rapid growth and increased physical activity.
During the growth spurt, the heel bone grows faster than the Achilles tendon, which attaches to the back of the heel. This creates tension and repeated stress on the growth plate, leading to inflammation and pain. Sever's disease is not a true disease but rather a temporary condition that resolves once the growth plates close, typically by the age of 15 or 16.
Causes and Risk Factors of Sever's Disease
Physical activities like football, basketball, and gymnastics, which involve running, jumping, or abrupt movements, heighten the risk due to their repetitive impact on the heels.
Biomechanical issues such as flat feet, high arches, or misalignment affecting the feet and ankles also contribute significantly to the condition. Additionally, excess weight and improper footwear lacking adequate support or cushioning further exacerbate stress on the heels, increasing susceptibility.
Symptoms and Diagnosis of Sever's Disease
The primary symptom of Sever's disease is heel pain, which can range from mild to severe. The pain is typically localised at the back of the heel, where the Achilles tendon attaches to the growth plate.
Symptoms of Sever's disease include limping or walking on toes to alleviate heel pressure, along with swelling or tenderness in the heel area. Patients may experience stiffness or tightness in the Achilles tendon or calf muscles, which can accompany pain that intensifies during physical activity but typically subsides with rest.
To diagnose Sever's disease, your healthcare provider will perform a physical examination and may order imaging tests, such as an X-ray or MRI, to rule out other potential causes of heel pain, such as fractures or other injuries.
Can You Play Sports with Sever's Disease?
While it is generally recommended to reduce or modify physical activity during the acute phase of Sever's disease, you may still be able to participate in sports with proper management and precautions.
To manage Sever's disease, begin by modifying activities to avoid high-impact exercises that involve repetitive jumping or running until symptoms improve. Switching to low-impact alternatives such as swimming or cycling can help maintain fitness without exacerbating heel stress. Ensure you wear well-cushioned shoes with good arch support to alleviate pressure on your heels and consider using heel cups or inserts for added comfort and support.
Additionally, incorporate a thorough warm-up and cool-down routine into your exercise regimen to prepare muscles and tendons for activity and aid in recovery afterward. After physical activity, apply ice packs to the affected heel area and use compression wraps or socks to minimise inflammation and swelling. Most importantly, listen to your body: if you feel significant pain or discomfort during or after activity, take a break to allow adequate rest and recovery time.
Tips for Preventing and Managing Sever's Disease
It's important to wear proper footwear—opt for well-cushioned shoes with good arch support and replace them regularly, avoiding hand-me-downs or worn-out pairs.
Incorporate cross-training activities like swimming or cycling to vary impact on your heels. Maintaining a healthy weight can alleviate stress on growth plates, lowering the likelihood of developing heel pain.
How Long Does Sever's Disease Last?
With appropriate treatment and management strategies, such as rest, icing, stretching, and the use of supportive footwear or heel cups, the symptoms of Sever's disease can often be alleviated within a few weeks to several months.
In most cases, Sever's disease resolves once the growth plates in the heel bone close, which typically occurs between the ages of 12 and 15 for girls and 14 and 16 for boys. However, the symptoms may persist for several months or even years if the condition is not properly managed.
It's important to follow your healthcare provider's recommendations and allow sufficient time for healing and recovery. Rushing back into high-impact activities before the condition has fully resolved can prolong the healing process and increase the risk of further injury.
Sever's Disease in Adults
While Sever's disease is primarily associated with children and adolescents, it is possible for adults to experience similar heel pain and inflammation due to overuse or repetitive stress on the heel area.
In adults, this condition is often referred to as "insertional Achilles tendinitis" or "calcaneal apophysitis." The underlying cause is the same – inflammation and irritation at the point where the Achilles tendon attaches to the heel bone.
Treatment Options for Sever's Disease
Sever's disease is typically treated conservatively, with a focus on reducing inflammation, alleviating pain, and promoting healing.
Start by prioritising rest and modifying activities to allow the growth plate in the heel to recuperate. This involves temporarily reducing or adjusting physical activities, such as sports or high-impact exercises, and opting for gentler options like swimming or cycling to maintain fitness without aggravating symptoms.
Alongside activity modification, applying ice packs to the heel for 15-20 minutes several times daily helps reduce inflammation and pain. Compression wraps or socks can further aid by providing support and minimising swelling.
For additional relief, over-the-counter NSAIDs like ibuprofen or naproxen can be beneficial in reducing inflammation and discomfort, though it's crucial to seek guidance from a healthcare provider before administering these medications to children or adolescents.
Physical therapy is also highly recommended, as a therapist can offer tailored stretching and strengthening exercises to enhance flexibility, correct biomechanical issues, and support healing.
Additionally, orthotics or heel cups, whether custom-made or over-the-counter, can help redistribute pressure and cushion the heel, thereby alleviating stress on the growth plate. In severe cases, immobilisation with a walking boot or cast may be necessary to ensure complete rest and optimal healing of the affected area.
It's essential to follow your healthcare provider's recommendations and be patient throughout the treatment process, as Sever's disease can take time to fully resolve.
Stretching Exercises for Sever's Disease
Stretching exercises can be an effective component of the treatment plan for Sever's disease. By improving flexibility and reducing tension in the muscles and tendons around the heel, stretching can alleviate pain and promote healing. Here are some recommended stretching exercises:
Calf Stretches
- Stand facing a wall, with your hands against the wall at shoulder height.
- Step back with one leg, keeping the knee straight and the heel on the ground.
- Lean forward, feeling the stretch in the calf muscle of the back leg.
- Hold the stretch for 30 seconds and repeat on the other side.
Achilles Tendon Stretches
- Stand with one leg in front of the other, keeping both feet flat on the ground.
- Bend the front knee while keeping the back leg straight and lean forward until you feel a stretch in the Achilles tendon of the back leg.
- Hold the stretch for 30 seconds and repeat on the other side.
Plantar Fascia Stretches
- Sit on the floor with your legs extended in front of you.
- Loop a towel or resistance band around the ball of one foot.
- Gently pull the towel or band towards you, feeling the stretch in the arch of your foot and heel.
- Hold the stretch for 30 seconds and repeat on the other side.
It's important to perform these stretches gently and avoid bouncing or forcing the movement. If you experience significant pain or discomfort, stop the exercise and consult your healthcare provider or physical therapist.
Using Heel Cups or Orthotic Insoles for Sever's Disease
Heel cups and orthotic insoles are simple and effective tools for managing Sever's disease. These cushioned inserts are designed to fit inside your shoes and provide additional support and cushioning for the heel area.
Heel cups, made of shock-absorbing materials, reduce impact and stress on the heel's growth plate during physical activity. By slightly elevating the heel, they redistribute pressure and lessen tension on the Achilles tendon and growth plate. Additionally, heel cups can correct biomechanical issues like overpronation or supination, which may contribute to Sever's disease. The cushioning they provide enhances comfort and support, alleviating pain and allowing more comfortable participation in physical activities.
Managing Sever’s Disease with Lightfeet
Here at Lightfeet, we are passionate about our products and customers. We emphasise the quality, comfort, and design of our eco-friendly products, and maintain our commitment to sustainability and helping people live pain-free lives.
Sever's disease can be a challenging condition for children and adolescents, but with the right approach, it is possible to alleviate the symptoms and continue participating in sports and physical activities. By understanding the causes, risk factors, and treatment options, you can take proactive steps to manage the condition and promote healing.
Remember to listen to your body, follow your healthcare provider's recommendations, and be patient throughout the recovery process. With proper rest, stretching exercises, supportive footwear, and appropriate activity modifications, Sever's disease can be effectively managed, and you can get back to enjoying the activities you love.
For orthotic solutions that you can start immediately to help manage the symptoms of Sever’s disease, Lightfeet offers a variety of podiatry-approved thongs, insoles for a variety of activities, and socks available for order.