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What the Heel is Sever’s Disease?

A kid’s body can grow fast, sometimes too quickly for it to keep up! You may have spent some evenings or nights soothing a child with achy legs from growing pains.

Adolescents and teens who are active in sports can also experience sharp heel pains that put them off their game. That’s a growing pain, too, called Sever’s disease.

Though the name and symptoms may be worrisome to both parents and players, it’s not as bad as it sounds, and a little preventive medicine can go a long way toward avoiding pain and getting kids back on their feet. Kate Richardson, an OhioHealth athletic trainer who works with kids at Dublin Davis Middle School, explains.

My child has Sever’s disease? Sounds scary.

“It’s not, really, and it’s fairly common,” says Richardson. “Sever’s disease is the common name for calcaneal apophysitis or inflammation of the growth plate on the back of the heel that causes pain. It often occurs to athletes during puberty.”

What causes the pain?

“The Achilles tendon connects your calf muscles to the heel bone near a growth plate. When kids go through a growth spurt, bones grow first and leave muscles lagging behind, which places tension on the Achilles tendon,” says Richardson. “Sports that involve a lot of running and jumping cause the tendons to pull on that growth plate, which causes inflammation and pain. During physical activity, kids will complain of pain on the back of the heel, where the tendon attaches to bone.”

What can you do to stop the pain?

“Unfortunately, stretching in the moment doesn’t really help, which can be a frustrating thing for athletes. You have to rest and limit painful activity to stop the pain,” says Richardson, “because if the injury progresses, an athlete can feel it during daily activities, such as walking.”

How long should you rest the injury?

“A lot of it depends on the sport, and whether an athlete’s activity involves a lot of running and jumping, like basketball or gymnastics. If we can identify and address Sever’s disease early, and kids can begin recuperating, they often feel better within a couple of weeks,” says Richardson. “If the inflammation is allowed to progress, it could take a month or longer, with a very gradual return to activity. In more serious cases, they may need to be in a protective boot or on crutches to allow the injury to heal.”

How do you diagnose Sever’s disease?

“An athlete will complain of heel pain during their sport activities, and they often have pain or sensitivity when the heel bone is squeezed from both sides. I also move their ankle through different ranges of motion and have the athlete perform activities that stress the tendon to see it’s painful for them,” says Richardson.

What can you do to recover from Sever’s disease, or avoid it?

“If an athlete is complaining of heel pain, I recommend parents follow up with a medical professional, such as an athletic trainer or physician, for a proper diagnosis and a plan of care. It’s a good idea to take some time off from activity, or modify activity and include stretches and strengthening exercises for the calf muscles and Achilles tendon,” says Richardson. “We typically start with rest and light stretching, and as symptoms improve we try to incorporate exercise and normal activity.”

“For any active teen, I recommend daily calf stretches. To stretch the calves, stand facing a wall with feet in a lunge position. Place your hands on the wall and lean forward until you feel a stretch just below your knee on your back leg. Keep your heels on the ground and back knee straight and hold the stretch for 30 seconds. Do that a couple of times every day,” says Richardson. “Stretching daily helps keep the calf muscles flexible so they’re more responsive to growing bones.”

Richardson also says it helps to properly warm up before activity. “Drills like skips, high knees, heel walks, toe walks and cariocas can warm up those tendons and better prepare kids for full activity.”

Want this information to take with you? Our sports medicine team put together this quick guide to Sever’s Disease for you.

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