Calcaneal Apophysitis (Sever鈥檚 Disease)

Q: Can Sever’s Disease cause permanent damage?

No, Sever’s Disease does not cause permanent damage. Once the growth plate fully develops, the pain typically goes away without long-term effects.

Is your child complaining of persistent heel pain? They may be experiencing Sever鈥檚 Disease (Calcaneal Apophysitis), a common condition in growing children. Learn about the causes, symptoms, and treatment options to help your child stay active and pain-free.

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Understanding Calcaneal Apophysitis (Sever鈥檚 Disease): Causes, Symptoms, and Treatment

If your child is experiencing persistent heel pain, they may be suffering from Calcaneal Apophysitis, commonly known as Sever鈥檚 Disease. This condition affects growing children and adolescents, particularly those involved in sports and physical activities. Although it is not a disease in the traditional sense, it is a painful inflammation of the growth plate in the heel bone (calcaneus). Understanding the causes, symptoms, and treatment options can help manage the condition effectively and prevent long-term discomfort.

What Is Calcaneal Apophysitis (Sever鈥檚 Disease)?

Calcaneal Apophysitis is a common overuse injury that affects the growth plate in the heel. The condition occurs when repetitive stress is placed on the heel during activities such as running, jumping, and playing sports. Since the growth plate is still developing, it is more susceptible to inflammation and irritation.

The condition is most commonly seen in children between the ages of 8 and 14, as this is a period of rapid bone growth. The Achilles tendon, which connects the calf muscles to the heel bone, can put excessive strain on the growth plate, leading to pain and swelling.

Common Causes of Sever鈥檚 Disease

Several factors contribute to the development of Calcaneal Apophysitis, including:

Repetitive stress and overuse 鈥� Sports such as soccer, basketball, and gymnastics that involve excessive running and jumping can strain the heel鈥檚 growth plate.
Rapid growth spurts 鈥� The bones, muscles, and tendons may not grow at the same rate, leading to increased tension on the heel.
Tight calf muscles and Achilles tendon 鈥� When the Achilles tendon is tight, it pulls on the heel bone, exacerbating inflammation.
Improper footwear 鈥� Shoes without proper arch support or cushioning can increase the impact on the heel.
Obesity or excess weight 鈥� Extra weight can add stress to the feet, worsening symptoms.

Symptoms of Calcaneal Apophysitis

The most common signs and symptoms of Sever鈥檚 Disease include:

Heel pain and tenderness, typically at the back or bottom of the heel.
Pain that worsens with physical activity and improves with rest.
Swelling and redness around the heel area.
Difficulty walking or limping, especially after sports activities.
Increased sensitivity when the sides of the heel are squeezed.

Diagnosing Sever鈥檚 Disease

A podiatrist or foot specialist can diagnose Calcaneal Apophysitis through a physical examination and medical history. In most cases, X-rays are not necessary, but they may be used to rule out fractures or other conditions. The podiatrist may perform a squeeze test, where gentle pressure is applied to both sides of the heel to check for pain and tenderness.

Treatment Options for Sever鈥檚 Disease

The good news is that Sever鈥檚 Disease is a temporary condition that resolves once the growth plate closes. However, treatment focuses on relieving pain, reducing inflammation, and preventing further irritation. Common treatment options include:

Rest and Activity Modification: Reducing or temporarily stopping high-impact activities can help alleviate symptoms.
Ice Therapy: Applying an ice pack to the affected heel for 15-20 minutes after activity can reduce pain and swelling.
Stretching Exercises: Regular stretching of the Achilles tendon and calf muscles can help relieve tension on the heel.
Orthotic Inserts and Supportive Footwear: Wearing cushioned shoes with proper arch support or using heel cups or custom orthotics can reduce heel impact.
Anti-Inflammatory Medications: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help with pain and inflammation.
Physical Therapy: A podiatrist may recommend strengthening and stretching exercises to improve flexibility and reduce strain on the heel.

Recovery and Prognosis

Most children recover from Sever鈥檚 Disease within 2 to 8 weeks with proper treatment and activity modification. However, in some cases, symptoms may persist for several months if not managed correctly. The key to preventing recurrence is to ensure gradual return to sports, proper warm-up routines, and wearing appropriate footwear.

Preventing Calcaneal Apophysitis

While Sever鈥檚 Disease cannot always be prevented, parents and young athletes can take steps to minimize the risk:

Encourage stretching exercises before and after physical activities.
Ensure your child wears well-cushioned, supportive shoes that fit properly.
Avoid excessive high-impact activities, especially during growth spurts.
Use orthotic inserts or heel cups to reduce stress on the heel.
Encourage gradual increases in activity levels instead of sudden intense training sessions.

FAQs About Sever鈥檚 Disease

Can Sever鈥檚 Disease cause permanent damage?

No, Sever鈥檚 Disease does not cause permanent damage. Once the growth plate fully develops, the pain typically goes away without long-term effects.

How long does it take for a child to recover from Sever鈥檚 Disease?

Recovery time varies, but most children feel relief within a few weeks to a few months with proper treatment.

Can a child continue sports while recovering?

It depends on the severity of symptoms. If the pain is mild, low-impact activities like swimming or cycling may be an alternative until full recovery.

Should my child see a podiatrist for heel pain?

Yes, if your child experiences persistent heel pain, it is best to consult a podiatrist for an accurate diagnosis and appropriate treatment.

Can shoe inserts help with Sever鈥檚 Disease?

Yes, heel cups or custom orthotics can help absorb shock and reduce strain on the growth plate.

Why Choose University Foot & Ankle Institute?

Calcaneal Apophysitis (Sever鈥檚 Disease) is a common but manageable condition in active children and adolescents. By recognizing the early signs and implementing proper treatment, parents can help their children recover quickly and return to pain-free activities. If your child is experiencing persistent heel pain, contact us to ensure a proper diagnosis and effective treatment plan.

At University Foot & Ankle Institute, our board-certified podiatrists offer expert care for conditions like Sever’s Disease. We provide advanced treatment options, from conservative care to surgical solutions, ensuring personalized care for every patient.

Written and Medically Reviewed by Dr. Bob Baravarian, DPM, FACFAS

ABFAS^庐聽Board Certified in Foot Surgery and Reconstructive Rearfoot and Ankle Surgery. and Director of University Foot and Ankle Institute

Dr. Bob Baravarian DPM, FACFAS is a Board-Certified Podiatric Foot and Ankle Specialist. He is an assistant clinical professor at the UCLA School of Medicine and serves as Director of University Foot and Ankle Institute.

Dr. Baravarian has been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy, and trauma/reconstructive surgery of the foot and ankle. He is also fluent in five languages (English, French, Spanish, Farsi, and Hebrew),

The UFAI Education Team

The UFAI Education Team is comprised of leading foot and ankle specialists at University Foot & Ankle Institute, dedicated to advancing patient care through education, research, and innovation. With decades of combined experience, our board-certified podiatrists provide expert insights into the latest treatments and surgical advancements. Committed to empowering patients with reliable information, our team ensures that every article reflects the highest standards of medical excellence.