Name = Severs
Caption = The mucous sheaths of the tendons around the heel. Lateral aspect. (Tendo calcaneus labeled at left.)
DiseasesDB = 11980
eMedicineSubj = orthoped
eMedicineTopic = 622
Sever's disease, or calcaneal apophysitis, is the most common cause of heel pain in the growing athlete and is due to overuse and repetitive microtrauma of growth plates of the
calcaneusin the heel. It occurs in children ages 7 to 15, with the majority of patients presenting between 10 and 12 years of age.
It is named for JW Sever, who characterized it in 1912. [Sever JW: Apophysitis of the Os Calcis. New York Medical Journal 1912; 95: 1025-1029.]
*Complaints of pain or tenderness in the
*Discomfort upon awaking, or when heel is squeezed
*More severe pain after walking and more difficulty walking
*Pain during running or playing sports
Sever’s disease is directly related to overuse of the
boneand tendons in the heel. This can come from playing sports(i.e. soccer, basketball, lacrosse, track and field) or anything that involves lots of heel movements. It can be associated with starting a new sport, or the start of a new season.cite journal |author=Hendrix CL |title=Calcaneal apophysitis (Sever disease) |journal=Clinics in podiatric medicine and surgery |volume=22 |issue=1 |pages=55–62, vi |year=2005 |pmid=15555843 |doi=10.1016/j.cpm.2004.08.011] Too much weight bearingdown on the heel can also cause it as can excessive traction since the bones and tendons are still developing. It occurs more commonly in children who pronate, and involves both heels in more than half of patients.
Treatment may consist of one or more of the following:
*Elevating the heel
*Stretching hamstring and calf muscles 2-3 times daily
*Using R.I.C.E. (Rest, Ice, Compression, Elevation)cite journal |author=Madden CC, Mellion MB |title=Sever's disease and other causes of heel pain in adolescents |journal=American family physician |volume=54 |issue=6 |pages=1995–2000 |year=1996 |pmid=8900359 |doi=]
Sever’s disease is self-recovering, meaning that it will go away on its own when it is used less or when the bone is through growing. The condition is not expected to create any long-term disability, and expected to subside in 2-8 weeks.
However, while the disease does subside quickly, it can recur, for example at the start of a new sports season, several times if it is not taken care of. ]
However, while the disease does subside quickly, it can recur, for example at the start of a new sports season, several times if it is not taken care of.
It is more common in boys aged 10-14, and Sever's usually subsides by the age of 17 if chronic symptoms appear.
*Maintain good flexibility through stretching exercises
*Avoid excessive running on hard surfaces
*Use quality, well-fitting
shoeswith firm support and a shock-absorbent sole
List of childhood diseases
Micheli and Ireland. Prevention and Management of Calcaneal Apophysitis in Children: An Overuse Syndrome. Journal of Pediatric Orthopedics 1987; 7(1): 34-38.
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