Sever’s disease is a common cause of heel pain in young athletes due to an inflammation or irritation of the growth plate on the back of the calcaneus (heel bone). It is typically seen in kids ranging from eight to 15 years old. It is common in sports that involve running, such as soccer, and repetitive impact, such as gymnastics. Treatment is always nonoperative. Rest from the offending activities, including sports, is essential to decrease the pain. Ice, anti-inflammatory medications, and rest are often all that is needed to resolve the symptoms.
Signs and symptoms of Sever’s disease
Young athletes with Sever’s disease typically complain of heel pain with sports or activity. The pain usually gets worse with an increase in activity. The pain almost always goes away after activity or with rest. Unlike plantar fasciitis, which typically causes heel pain that is felt on the sole of the foot, Sever’s disease usually has pain on the back of the heel just past where the Achilles tendon attaches. Often a sports medicine physician can diagnose Sever’s disease by eliciting tenderness on the posterior aspect of the calcaneus or by squeezing the sides of the calcaneus together to reproduce the pain. X-rays will often show increased density of the growth area on the back of the calcaneus.
Treatment options for Sever’s disease
Treatment for a young patient with Sever’s disease is always nonoperative. If needed for pain, the athlete can use crutches to keep weight off the heel and decrease the pain. Often crutches are unnecessary. Rest from the offending activities and sports, such as gymnastics and soccer, is essential to decrease the pain. Ice, anti-inflammatory medications, and rest can often resolve the symptoms. Sometimes heel cups can be helpful to prevent stress on the calcaneus.
Stretching exercises for the Achilles and hamstrings and working with a physical therapist can be helpful as well. If the symptoms are not improving, wearing a night splint or even putting the patient in a short leg cast can eliminate the symptoms. Return to sports can be tricky, but the athlete can go back to play whenever the symptoms resolve to the point that the he or she can play without pain.
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