Sever’s Disease in Athletic Children

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Joseph Halphen PA-C, Lake After Hours Central

Sever's apophysitis is the most common cause of heel pain in the growing athlete and is due to overuse and repetitive micro trauma of growth plates of the calcaneus (heel). It occurs in children ages 7 to 15, with the majority of patients presenting between 10 and 14 years of age. This time of year at Lake After Hours we see a few of these patients a week, usually during the beginning of baseball season.

The symptom of Sever’s apophysitis (AKA Sever’s disease) is heel pain which increases in intensity during running and jumping activities. The pain is localized to the very posterior aspect of the heel, and is only elicited with weight-bearing. Discomfort is typically brought on with running during sports, specifically soccer, baseball, and basketball. These symptoms can be severe, with pain and limping noticed with activities of daily living (i.e. walking). The pain usually subsides with rest.

Treatment of symptoms consists of over the counter non-steroidal anti-inflammatory medications, stretching and implementation of Quag heel inserts in the child's shoes.  The Quag heel insert is made of soft 1/2 inch Poron, which is a high shock absorber, thus reducing the trauma to the heel as well as elevating the heel which reduces the stress of the Achilles tendon attachment to the back of the heel. Stretching of the hamstring and calf muscles has also been strongly recommended. Sever’s is a self-limiting condition, which resolves when the physis (growth plate) closes, in girls this is at approximately 12 to 14 years old and boys at 15 to 17 years old. No long-term problems have been linked with Sever's apophysitis.

Sever's disease may be prevented by maintaining good flexibility while your child is growing. The stretching exercises can lower your child's risk for injuries during the growth spurt. 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 applying ice on the heel after activity will help keep your child from developing this condition again.


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