Child heel Pain=Sever's disease

(Calcaneal apophysitis)

 

Sever's disease is a common  musculoskeletal  complaint in children between the ages of 8 and 15. Presenting as heel pain.

 

It is a traction caused apophysitis of the growth plate (inflammation of the growth plate) occuring where the achilles tendon attaches to the calcaneus (heel bone).  Pain is normally worse with increased activity and painful on squeezing the heel.

It is believed to be caused by increased pulling on the calcaneus associated with growth and tight achilles and calf muscles. It is also related to high or repeated minor impact forces to the heel.

I commonly see this in young soccer and football players and they typically wear very flat boots with no heel raise. Sever's  disease is more common to male children who are very active or over-weight.

Treatment involves:

1. Treatment of inflammation- rest, ice,  compression and elevation.

2. Advice on footwear to reduce impact forces and lift the heel to reduce traction.

3. Reduce tension using heel raises.

3. Gentle stretching of calf muscles.

5. Modifying activity is important.

REMEMBER. Many injuries are induced by failure to allow the body to adapt slowly to increasing load. Sudden and big increases in load will often cause tissue failure and result in injury in adults and children.

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