As a parent, I want my kids to have active healthy lives and here in Central Oregon, we have many opportunities for children to get outside and participate in physical activities, from soccer to skiing. Sever’s disease is one of the more common foot conditions that can occur in active kids and adolescents, and it is something I see from time to time.

Sever’s disease (also known as Calcaneal Apophysitis), is not a true “disease”, but is a painful inflammation of the heel’s growth plate that usually occurs from age 8 to 14. At this time, the heel bone is still developing and new bone is forming at the growth plate in the heel. If there is too much repetitive stress on the growth plate while it is developing, it can become inflamed and painful.

Sever’s disease is caused by repetitive running or jumping on hard surfaces. For this reason, children and adolescents involved in soccer, track, basketball or similar activities are particularly vulnerable. Other factors that might help cause this ailment include obesity, a tight Achilles tendon, and biomechanical problems such as a flatfoot or high-arched foot.

Your child might complain about, or you may notice the following symptoms:

• Pain in the back or bottom of heel
• Limping
• Walking on toes
• Difficulty running, jumping or participating in usual activities or sports
• Pain when the sides of the heel are squeezed

Full diagnosis is needed for a child with heel pain to rule out other conditions. Treatment options vary, but may include:

• Reduction in activity that causes the pain.
• Prescribed shoe inserts or custom orthotics that support the heel and eliminate related biomechanical issues.
• Medications such as NSAIDs—ibuprofen, to reduce pain and inflammation.
• Physical therapy or stretching exercises to promote healing of the inflamed tissue.
• Immobilization for severe cases to keep the foot and ankle immobile to promote healing.

Sometimes heel pain in children can return after it has been treated because the heel bone is still growing. Recurrance of heel pain can indicate a return of Sever’s disease or a different condition, so it is important to re-evaluate if the pain returns.

–Dr. Frank, 541-385-7129