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Sever Disease

Sever disease, a.k.a. calcaneal apophysitis, is a painful inflammation of the calcaneus or heel bone. 
Sever disease, a.k.a. calcaneal apophysitis, is a painful inflammation of the calcaneus or heel bone.  This inflammation primarily impacts children and teenagers during their developmental ages as their bones are not fully developed and can get inflamed.  In every growing child, there is a “growth plate” or apophysis near the end of each bone (both at the top and bottom), which is spongy and not fully hardened to allow for growth and development during adolescence.  As children and their bones grow, occasionally the muscles/tendons that attach to these bones do not develop as quick and can pull and irritate these bones at the apophysis (“growth plate”).  This prolonged pulling can cause pain and inflammation, and in Sever’s disease specifically, heel pain.
In the case of Sever’s disease, this pain and inflammation is likely caused by repetitive micro-trauma or stress from the Achilles tendon pulling on the “spongy” or developing bone in the heel (calcaneus).  This pain and inflammation frequently occurs before or during a peak growth spurt in children.  Another common diagnosis with a similar pathology or cause is Osgood-Schlatter Disease, which is tibial tubercle apophysitis (a painful bump near the top of the shin bone near the knee).  This “bump” is excess bone that can form in the heel (in Sever) or bottom of the knee (in Osgood-Schlatter) as a result of an excess pull from the muscle/tendons on the developing bone.  Both in Sever and Osgood-Schlatter disease, these areas become less painful as the bone full develops and hardens once the adolescent finishes puberty.
            Typical treatment for Sever disease is rest and ice to reduce pain and inflammation.  Also, a heel wedge in the shoe of the child/athlete can reduce the pull or stress on the bone from the Achilles tendon.  Physical Therapy can be helpful too to improve stability and flexibility in the foot and lower leg.  Physical Therapy utilizes all of the above options, depending on the specific needs of the child, to quickly reduce symptoms and return the child to sport or activities pain free.  If not properly treated early, the pull from the Achilles can develop a significant bony deformity on the heel which can cause further problems into adulthood, even after the bone fully forms.

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Pediatric Associates PSC - Crestview Hills | 2865 Chancellor Drive | Suites 225 (Upstairs) and 120 (Down Under) | Crestview Hills, KY 41017 | Phone: 859-341-5400 | Fax: 859-578-3172
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