You know what they say—kids grow up so fast! Bones grow faster in the foot than other tissues, so if your child is going through a growth spurt, his or her muscles and tendons can tighten and pull. The Achilles tendon, which is attached to the heel bone, can pull on the bone’s growth plate. Sever’s disease, also known as calcaneal apophysitis, occurs when the growth plate in the back of the heel becomes inflamed. This condition is one of the most common heel injuries seen in children and adolescents, especially those who are active or regularly participate in sports. If your child is complaining of heel pain, Sever’s disease could very well be the cause.
The reason why this disease is rarely seen in adults is because the heel bone hardens and becomes stronger after the growing process is over; therefore it is less prone to problems. Typical symptoms of the condition include heel pain or tenderness that increases over time and occurs mostly with activity. Children in sports that involve running and jumping a lot—like baseball, gymnastics, basketball, soccer, and football—are most commonly affected. It’s important to note that discomfort tends to go away with rest, and seldom occurs in low-impact sports like biking or swimming.
Some children may have predisposed characteristics, like flat feet or high arches, which make them more susceptible to having problems. In other words the condition can run in the family. If your child is born with certain inherited traits, they could be more at risk. Arches affect the position of your heel, which in turn affects your Achilles tendon. Short Achilles tendons exaggerate tightness and increase the pull on the heel’s growth plate. If your child’s foot rolls too far outward when walking, also known as pronation, the heel is forced to bear too much weight. In addition, those born with one leg shorter than the other can be affected since the shorter leg’s foot must over-stretch to reach the ground.
In the special circumstances listed above, treatment of Sever’s disease must also include treatment of the underlying problem. Otherwise, to take pressure off of the heel bone, treatment mainly consists of rest. Children should take time off from their sport and may be required to do some physical therapy exercises. Stretches specifically for the calf and Achilles are especially helpful. Wrapping ice in a towel and propping the affected heel on top can reduce pain and inflammation as well. A gradual return to activity is recommended, and corrective shoe inserts or heel lifts may be prescribed.
Sever’s disease usually goes away once the growth plate has matured. In the meantime, if your child is suffering from heel pain, have Dr. Sanjay Patel examine his or her foot and determine the best course of action. Give us a call—203-876-7736 for the Milford location, or 203-288-4055 for the Hamden office—or fill out our contact form to reach us. Kids don’t have to suffer in pain. We can help get them back in the game!