Heel pain can also occur in children, most commonly between ages 8 and 15, as they become increasingly active in sports activity in and out of school. This physical activity, particularly jumping,
inflames the growth centers of the heels, also known as the apopyhsis. The more active the child, the more likely the condition will occur. Your doctor may also describe the condition as Sever's
Disease or calcaneal apophysitis.
The heel bone sometimes grows faster than the leg muscles (including the calf muscles) and tendons (including the Achilles tendon) during the early puberty growth spurt. The different growth rate in
these structures can cause lower leg muscles and tendons to become overstretched and tight, which makes the heel less flexible and puts excessive pressure on the heel growth plate. The Achilles
tendon, the strongest tendon in the body, attaches to the heel growth plate, and repetitive stress on this structure, especially if it?s already tight, can damage the growth plate, leading to
tenderness, swelling, and pain. Activities that involve running or jumping, such as soccer, gymnastics, track, and basketball, can place significant stress on a tight Achilles tendon and contribute
to the onset of Sever?s disease. Ill-fitting shoes can also contribute to this health problem by failing to provide the right kind of support or by rubbing against the back of heel. The following
factors may increase the likelihood of Sever?s disease in kids or young teens. Wearing footwear that is too narrow in the toe box. Leg length inequality. Obesity or carrying excess bodyweight.
Excessive foot and ankle pronation.
Pain in the lower calf and heel area which may be worse when applying pressure either side. Pain worse on activity especially those involving running or jumping. In severe cases this may cause the
child to limp when walking. One or both heels affected.
A physical exam of the heel will show tenderness over the back of the heel but not in the Achilles tendon or plantar fascia. There may be tightness in the calf muscle, which contributes to tension on
the heel. The tendons in the heel get stretched more in patients with flat feet. There is greater impact force on the heels of athletes with a high-arched, rigid foot.
Non Surgical Treatment
Sever?s disease is a self-limiting problem, because as your child grows the growth plate will eventually fuse with the main body of the heel bone. This happens at about 14 -15 years of age. Once foot
growth is complete and the growth plate has fused, the symptoms will resolve. In the meantime, treatment by your Podiatrist will help your child return to normal sporting activities without heel pain
slowing him/her down.
Having Sever?s disease does not predispose children or teens to any other condition, nor is it a permanent problem. It is self-limiting, and when treated, the pain and other symptoms will abate
within a few weeks. Once the growth plate has finished growing, Sever?s disease will resolve and won?t recur. It is important to continue to treat any underlying foot conditions and to avoid any long
periods of inactivity.