Sever's disease is a condition that affects adolescents. It is a painful inflammation of the growth plate or epiphyseal plate, in the heel bone.
It affects adolescents during their growth spurt in puberty. This is typically between eight and 13 for girls and 10 and 15 for boys. After this time, growth at the heel finishes, the bones at the heel fuse together and the inflammation subsides.
The inflammation can occur because the soft tissues connected to the heel sometimes grow more quickly than the bone itself, putting pressure on the bone.
It is more common in active adolescents.
The main symptoms are pain or tenderness in one or both heels, usually at the back.
Other symptoms may include swelling or redness at the heel, difficulty walking, stiffness upon waking, and discomfort when the heel is squeezed at both sides.
A diagnosis is made based on the symptoms. Squeezing the heel to bring on pain is also a diagnostic test. X-rays and imaging do not diagnose Sever's but they may be used to rule out other injuries such as fractures.
Sever's disease is treated by rest, anti-inflammatory pain relief, ice and elevation.
In many cases of Sever's the biomechanics of the foot type may increase the chances of developing the disease. These are common foot types that can be causal:
- A pronated foot type will cause tightness of the Achilles tendon, which increases the stress over the heel bone.
- A high arched foot can also cause tightness over the Achilles tendon.
- A leg length discrepancy will cause uneven stress on the heel of the shorter leg.
Foot orthotics will help in all these foot types, by normalising the foot posture, particularly the hind foot and reducing stress at the heel caused by a tightened Achilles heel.