Sever disease refers to a calcaneal apophysitis (an inflammation of the apophysis of the heel) which occurs in children and young adolescents. It typically presents in active young children (especially ones who engage in jumping and running sports).
Apart from age, other factors that may contribute to developing Sever?s disease include physical activity, any form of exercise that is weight bearing through the legs or stresses the soft tissue can exacerbate the pain of the disease. External factors, for example, running on hard surfaces or wearing inappropriate shoes during sport. Overuse injury, very active children may repeatedly but subtly injure the bones, muscles and tendons of their feet and ankles. In time, the accumulated injuries cause symptoms.
Acute pain, pain asscoiatied with Sever?s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running. Highly active - children who are very active are among the most susceptible in experiencing Sever?s disease, because of the stress and tension placed on their feet.
The x-ray appearance usually shows the apophysis to be divided into multiple parts. Sometimes a series of small fragments is noted. Asymptomatic heels may also show x-ray findings of resporption, fragmentation and increased density. But they occur much less often in the normal foot. Pulling or ?traction? of the Achilles tendon on the unossified growth plate is a likely contributing factor to Sever?s disease. Excessive pronation and a tight Achilles and limited dorsiflexion may also contribute to the development of this condition.
Non Surgical Treatment
The immediate goal of treatment is pain relief. Because symptoms generally worsen with activity, the main treatment for Sever's disease is rest, which helps to relieve pressure on the heel bone, decreasing swelling and reducing pain. As directed by the doctor, a child should cut down on or avoid all activities that cause pain until all symptoms are gone, especially running barefoot or on hard surfaces because hard impact on the feet can worsen pain and inflammation. The child might be able to do things that do not put pressure on the heel, such as swimming and biking, but check with a doctor first.
Severs disease is a self limiting condition that gradually resolves as the patient moves towards skeletal maturity. This usually takes between 6 to 12 months, but may persist for as long as 2 years. With appropriate management, symptoms may resolve in a number of weeks. Patients with Severs disease typically improve gradually over time and full function is restored.