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Written by our Human Movement Specialists

As parents and caregivers, it's natural to be concerned when your young one's experience discomfort, especially when they're passionate about staying active. Navigating how to handle and treat the symptoms of Sever's disease can feel overwhelming, so we've compiled practical tips and techniques to help you. Read on to find relief for your child's heel pain!

What is Sever's disease?

It's a common condition that primarily affects preadolescent and adolescent children, usually between the ages of 8 and 15. But don't let the name fool you – it's not an actual disease but rather a temporary inflammation of the growth plate in the heel bone, otherwise known as calcaneal apophysitis. The inflammation is usually attributed to sports and physical activities that involve running and jumping, like soccer or basketball.

Causes of Sever's Disease

The primary cause of Sever's disease is the rapid growth of bones during adolescence. Bones lengthen faster than the muscles, and tendons can adapt as they grow. This growth discrepancy places increased stress on the attachment point of the Achilles tendon to the heel bone, also called your calcaneus. The repetitive pull of the Achilles tendon on the growth plate can lead to discomfort in the heel area. It resolves itself when the growth plate has stopped growing.

Girls playing soccer

Symptoms of Sever's Disease

  1. Heel Pain: This is the most common symptom and occurs in the back or bottom of the heel. It is usually more pronounced during or after physical activities.

  2. Limping:  Children with Sever's disease may be reluctant to put weight on the affected heel to avoid pain, resulting in a slight limp.

  3. Tenderness: The heel area might be sensitive to touch and show signs of swelling or redness.

Treatment options for Sever's disease

The primary goal of treatment for severe disease is to relieve pain, promote healing, and prevent future episodes until the growth plate is finished growing. Treatment options may vary depending on the severity of the condition and your child's needs. Here are some commonly recommended treatments for Sever's Disease:

1. Rest and activity modification: Rest from sports or activities aggravating the condition may often be recommended. This allows the inflamed growth plate to heal and prevents further irritation. 

2. Stretching and strengthening: Performing exercises that target the calf muscles, Achilles tendon, and plantar fascia will help improve flexibility and reduce the strain on the growth plate in the heel.

3. Proper footwear: The right footwear can significantly affect their comfort and help alleviate symptoms. Here are some factors to consider when selecting footwear for severe disease:

  • Cushioning and shock absorption: opt for shoes with adequate cushioning and shock absorption to absorb impact during physical activity. This helps reduce stress on the growth plate in the heel.

  • High heel drop: This is the difference in stack height between the heel and forefoot. If you put your hand inside the shoe and move down towards the toe it should feel like a slide or ramp downwards. The bigger the difference, the better it will offload the Achilles tendon which in turn will provide pain relief.

  • Proper fit: Ensure the shoes fit well and supply enough room for the toes to move freely. Shoes that are too tight or too loose can contribute to discomfort and worsen symptoms.

4. Custom orthotics: These orthotic inserts are tailored to the unique contours of your child's feet, considering their specific needs, foot structure, and any existing medical conditions. By promoting proper foot alignment and distributing pressure more evenly, custom orthotics reduce the impact of repetitive movements, thus minimizing pain and inflammation. Moreover, they can address biomechanical imbalances contributing to the condition, aiding in long-term recovery and injury prevention. 

Someone putting heel cups in running shoes to help with Sever's disease

5. Heel cups or heel lifts: These orthotic devices sit under the heel at the back of the shoe and can provide significant relief for children dealing with Sever's disease by reducing the stress on the Achilles tendon. Benefits include:

  • Shock Absorption: Added cushioning distributes pressure, reduces impact on the growth plate when the child engages in physical activities, and minimizes strain on the inflamed area to help alleviate discomfort.

  • Support: The heel cup or heel lift's thickness can help prevent the Achilles tendon's overstretching, thereby reducing tension on the growth plate. The added support can also help stabilize the foot during movement to reduce the risk of further irritation.

  • Improved Mobility: By alleviating pain and discomfort, the child may be able to return to the activities they enjoy.

6. Ice therapy: Applying ice or a gel pack to the affected area can help reduce inflammation and relieve pain. Make sure to wrap in a thin towel as to avoid skin irritation. Apply for 15-20 minutes at a time, several times a day.

Every child is unique, and their treatment plan should be too. Our Canadian Certified Pedorthists are trained to assess for and design custom foot orthotics, give footwear recommendations as well as provide effective stretching techniques.

Make an appointment to see how Paris everyBODY can help your young athlete get back on track and recover from Sever's disease.


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