Severs Disease, also known as traction apaphysitis, is the inflammation of the growth plate of the heel and is common in active adolescents, particularly boys. The muscles of the calf attach via the Achilles tendon into the heel bone. Prior to skeletal maturity, a growth plate exists close to where the Achilles tendon attaches and provides an area of potential weakness.
Severs Disease is essentially an overload injury which occurs with high levels of sporting loads and/or due to a rapid growth phase when the leg bones lengthen faster than the leg muscles can adapt. This results in excessive shearing forces on the immature growth plate and ultimately inflammation and pain under load.
Aggravating Factors
- Excessive impact activity, such as running/jumping.
- Rapid growth spurt.
- Inappropriate footwear (such as worn school shoes or incorrect sports shoes)
- Poor foot and lower limb biomechanics.
- Posterior heel pain during/after activity.
- Morning stiffness and pain, especially the first few steps of the day.
Symptoms
Severs disease is a self-limiting condition generally resolving once the bone has completed growing. It can give considerable discomfort to the growing child, and it is important that it is not written off as ‘growing pains’.
Management
Severs disease is a self-limiting condition generally resolving once the bone has completed growing. It can give considerable discomfort to the growing child, and it is important that it is not written off as ‘growing pains’.
Management involves an assessment of possible contributing factors and may involve:
- Stretching and releases to the leg muscles.
- Identification and correction of any predisposing biomechanical factors.
- Advice on the appropriate amount of physical activity per week.
- Advice on appropriate footwear.
- A heel raise regular icing can help to further reduce the load on the area.
- Severe flare ups may initially require complete rest to reduce heel pain.
If your child is experiencing heel pain, book an appointment with one of our experienced physios today!