What is Sever’s disease?
Sever’s disease is a common cause of heel pain in young athletes. The medical term is calcaneal apophysitis which means there is inflammation of the growth plates in the heel (calcaneus).
What causes Sever’s disease?
It can occur in young athletes who take part in running or jumping sports. When participating in these sports there is increased load transferred from the Achilles tendon to it’s attachment the calcaneus (heel). The increased load through the Achilles tendon can cause irritation or inflammation of the growth plates, especially during growth spurts.
Symptoms of Sever’s disease.
Symptoms are usually worse during increased physical activity and can be present in both heels at the same time, although one may be worse than the other. Some common symptoms are:
Apophysis: Is a normal developmental outgrowth of bone which arises from a growth plate.
Epiphysis: is the end of the bone. The epiphyseal plate is the growth plate where the formation of bone takes place.
Calcaneus: is the heel bone.
Examination of the foot and ankle
There are a few key tests that we perform when examining a patient who we suspect could have Sever’s disease. A simple squeeze test of the heel can be painful. Ankle range of motion and calf strength is important. Any issues here will mean that our rehabilitation program will have stretches and or exercises to help correct this.
Other tests include heel raises, hopping and bounding tests. MRI scans might show signs of inflammation around the growth plate.
How to treat Sever’s disease
The good news is that Sever’s disease is what’s considered a “self-limiting” condition. That means that the condition will improve on its own regardless of what treatment the athlete receives. The reason for this is that their growth plates will fuse as they reach skeletal maturity.
It is recommended that an athlete takes a break from high-impact activity until their heel pain settles down to a level that they can tolerate. They can continue to train in the gym or cross-train on the bike or in the pool to maintain strength and aerobic capacity.
Although the condition will improve without any treatment, there are techniques that we can use to help reduce heel pain during flare-ups and allow the athlete to continue with their sport. In the video at the top of the page, I’ve demonstrated a taping technique using a product called dynamic tape. The tape is highly elastic and is used to control the load through the Achilles tendon and to create a compressive force around the active growth plates in the heel.
This taping method combined with a specific strength and mobility program can help an athlete reduce time lost from their chosen sport.