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My grandson is a fantastic soccer player. Suddenly he has developed heel pain they call Sever disease. What is Sever disease? Is this really supposed to be "severe" disease?
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You have the name correct; Sever disease. Sever disease is also known as Sever syndrome or by its medical term: calcaneal apophysitis. Sever disease is a painful heel condition that affects growing adolescents between the ages of nine and 14.
In this condition, the growing part of the heel bone grows faster than the tendon that connects on the back of the heel. This tightens up the tendon and creates tension where it attaches to the heel. Eventually, the tension causes the area to become inflamed and painful. Fortunately, the condition is not serious. It is usually only temporary.
Heel pain is the main symptom. The back of the heel may appear red and swollen. It will probably be tender to the touch. Squeezing the heel is painful. The heel and foot may feel stiff, especially first thing in the morning. The heel tends to hurt during activity and feel better with rest. The calf muscles and Achilles tendon may also feel tight.
Youth who play running and jumping sports (especially on hard surfaces) are most prone to this problem. Sever disease or syndrome used to happen mostly in boys. But with more girls playing sports, boys and girls are now affected equally. Both heels hurt in more than half the cases.
Once the diagnosis has been made, treatment consists of activity modification (the child may have to stop participating in sports activities for a short period. Children with Sever syndrome should avoid running on hard surfaces. Running barefoot should be avoided. The impact worsens the pain and inflammation. This gets the pain and inflammation under control. Usually patients don't need to avoid sports for a long time.
Sometimes, the passing of time may be all that is needed. It takes one to two years for the bone growth plates that make up the back of the heel to grow together and form one solid bone. At this point, pain and symptoms usually go away completely.
The doctor may prescribe anti-inflammatory medicine to help reduce pain and swelling. A small lift or pad placed under the sore heel may help, too. The lift angles the foot down slightly. This angle relaxes the Achilles tendon and reduces stress where the tendon attaches on the back of the heel.
The doctor may also suggest working with a physical therapist. Physical therapists might use ice, heat, or ultrasound to control inflammation and pain. As symptoms ease, the physical therapist works on flexibility, strength, and muscle balance in the leg. The therapist may also design special shoe inserts, called orthotics, to support the arch and take tension off the Achilles attachment. Taping the arch is an option when orthotics won't work, such as in footwear used by gymnasts and ballet dancers.
Cortisone injections are commonly used to control pain and inflammation in other types of injuries. However, a cortisone injection is usually not appropriate for this condition. Cortisone injections haven't shown consistently good results for Sever syndrome. There is also a high risk that the cortisone will cause the Achilles tendon to rupture.
In severe cases, when other forms of treatment don't give relief, doctors may recommend a walking cast for six to 12 weeks. The goal is to stop the foot from moving so that inflammation and pain go away. The symptoms of Sever's syndrome usually disappear when the growth plates in the heel grow together. Surgery is not generally an option for Sever's syndrome.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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