Severs disease is a pain in one or both heels when walking. The pain comes from the area between the sections of bone that make up the heel
As a young person goes through a growth spurt, the tendon at the back of the heel (Achilles Tendon) pulls at the heel bone. This causes inflammation of the growth plate (an area of developing bone) in the heel.
The reason the tendon is tight is because your bones grow faster than your muscles.
It usually affects:
- Boys between 8 to 10 years old
- Girls between 10 and 12 years old
- Children in a growth spurt
- Children involved in sports, usually those that involve running and jumping
What Causes Severs Disease?
Sports involving running and jumping such as athletics, basketball, gymnastics and football increase the risk of Severs Disease. Poor fitting shoes, flat feet and leg length discrepancies also increase the susceptibility to Severs Disease.
Signs and symptoms are usually worse during and immediately after activity and subside with rest and include:
- Swelling and redness of the heel
- Stiffness of the feet on waking in the morning
- Discomfort when both sides of the heel are squeezed at the same time
- Walking on tiptoes
- Walking with a limp
How can Severs be managed?
There is nothing you can do to stop Severs Disease from occurring. It will stop when the body stops growing and may come and go intermittently with growth spurts. Usually one bad spell is seen, then lesser versions may continue with future growth spurts. However, the following will help relieve the symptoms:
Rest – cut down on the time you spending playing sport until the pain has gone/is more manageable. Avoiding sports that involving a lot of running and jumping can reduce pain quickly. Swimming can be an excellent alternative sport whilst pain is a problem
Ice – icing the affect area for 10-15minutes, especially after activity, making sure you protect the skin by wrapping the ice in a towel
Elevation – raise the leg when painful and swollen, especially after sports
Pain relief – pain relieving medication may help reduce pain and swelling but please discuss the most appropriate type and dose with your pharmacist or GP
Shoes – hard soled shoes and barefoot time can actually make the pain worse, good supportive trainers, possibly with a gel heel cup (available from most chemists/Amazon) will help support the foot and ease the heel pain.
Stretches – 3-4 x each day when warm, after school or training, after a shower etc
Place one leg in front of the other with both feet facing forward.
Bend your front leg and keep your back straight.
Stretch will be felt in the mid to top part of the your calf muscles, sometimes a little behind the knee too.
Hold for 30seconds, repeat x4 each leg.
Place one foot with the toes at the wall, other foot stepped back slightly, both feet facing forwards.
Keeping the heel down at all times, take the front knee towards the wall. If your knee comfortably reaches the wall, inch the front foot back a couple of cms and try again, knee to wall.
The stretch will be felt in the lower calf, hold for 30 seconds, repeat x4 each leg. (See Image)
Recovery from Severs Disease
It may take several weeks or months for the pain to completely stop. In most cases, Severs disease will go away on its own with time and relative rest. When the pain has completely gone, you can slowly return to full levels of activity. If symptoms return with future growth spurts, stretches should be restarted and advice above followed.
If your child experiences other aches and pains that do not fit the descriptions above, please do not hesitate to gain an assessment to ensure the best and most appropriate treatment to get on top of symptoms.