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By Jennifer Mohns, DPT

Does your child complain of heel pain?  It is painful to stand or play sports? This condition is actually pretty common in children who participate high impact sports such as soccer, basketball, and volleyball.  This pathology is called Sever’s Disease.

Sever’s Disease is a bone injury that occurs at the back of the heel in children. This is the site in which the Achilles tendon attaches to the calcaneus (heel bone), and causes inflammation around the tendon and other supporting structures. The cause of the disease is simply that the calcaneus grows faster than the tendons and ligaments in the area. This creates a problem as children are going through a growth spurt, and the muscles and tendons become tight and possibly overstretched.  This disease is especially common because the foot is one of the first parts of the body to grow to full capacity, therefore, interrupting the growth process.

Sever's disease

The most important symptoms to look for with your child are tenderness or pain at the heel, limping or difficulty with standing and walking, redness or swelling in the heel region.  This disease can occur in one heel or both.

What is happening to the heel when my child has Sever’s disease and is growing?  First of all, the swollen heel causes pain and irritation to the tissues and muscles around the ankle and specifically the heel, which usually limits the child’s range of motion and ability to stretch. Over time the gastrocnemius muscle becomes tight and weak and therefore does not support the Achilles tendon and heel like it should.  When children with Sever’s disease participate in high impact or running sport activity the symptoms of the disease manifest at a much faster speed.

How do I get my child tested for Sever’s disease?  You can either take your child to their primary care doctor or to a physical therapist. An x-ray is used to help rule out a fracture at the heel, but it rarely picks up the swelling or abnormality. The doctor or physical therapist will put the child through a couple of physical tests in order to diagnosis the disease.

Treatment for Sever’s disease varies depending on the severity of the disease.  First, the child must rest and take a break from high impact physical activity for a couple of weeks in order to relieve the pressure from the heel bone. In more severe cases, children will be put in walking boot or brace to aide in the healing process.  Applying ice and taking Ibuprofen or another NSAID will help to decrease swelling and pain.

Dr. Mohons is a Physical Therapist at Boston Sports Medicine