Sever's Disease: A Guide to Heel Pain in Active Children
Watching your child enjoy sports and play is a wonderful part of parenting. However, when they start complaining of heel pain, it can be a source of concern for any family. One of the most common causes of heel pain in active children is Sever's Disease.
While the term "disease" can sound alarming, Sever's Disease is a manageable, self-limiting condition related to growth and activity. Osteopathy offers a gentle, whole-body approach to help young people manage their symptoms, stay active, and support their bodies through this temporary phase of development.
Key Facts About Sever's Disease
A Growth-Related Condition: Sever's Disease (calcaneal apophysitis) is not a true disease but an inflammatory condition of the growth plate in the heel bone (calcaneus). It occurs where the Achilles tendon attaches to the heel.
Common in Growing Children: It most frequently affects children between the ages of 8 and 14 who are going through growth spurts.
Self-Limiting: The pain from Sever's Disease typically resolves on its own once the growth plate fuses, usually by age 15. However, proactive management is crucial for comfort and maintaining activity.
What Causes Sever's Disease?
Sever's Disease is caused by repetitive stress on the heel's growth plate. During a growth spurt, a child's bones often grow faster than their muscles and tendons. This can lead to:
Muscle-Tightness: The calf muscles (gastrocnemius and soleus) and the Achilles tendon can become tight, increasing the pull on the growth plate at the back of the heel.
Repetitive Impact: Activities that involve a lot of running and jumping (e.g., soccer, basketball, athletics, netball) place significant force on the heel.
Biomechanical Factors: Issues with foot posture, such as flat feet or high arches, can alter how weight is distributed and increase stress on the growth plate.
The Perfect Storm: The combination of a growth spurt, tight muscles, high-impact sports, and sometimes less-than-ideal footwear can overwhelm the growth plate, leading to inflammation and pain.
Common Signs and Symptoms
Heel Pain: Pain at the back or bottom of one or both heels.
Pain with Activity: Pain that worsens during or after sports or physical activity.
Limping: A noticeable limp, especially after activity.
Tenderness: Pain when the sides of the heel are squeezed.
Morning Stiffness: Stiffness or pain in the heel upon waking.
How Can Osteopathy Help with Sever's Disease?
Osteopathic management of Sever's Disease focuses on reducing pain, addressing the muscular and biomechanical factors contributing to the condition, and supporting the body’s natural healing processes. We use a gentle, hands-on approach suitable for growing bodies.
During a consultation, we will:
Take a detailed history of your child's pain, activities, and growth patterns.
Perform a gentle physical examination assessing the foot, ankle, and evaluating muscle tightness and joint mobility.
Conduct a biomechanical assessment of their posture, gait (how they walk), and the function of their feet, knees, and hips.
What Does Osteopathic Treatment Involve?
Treatment is always tailored to the individual and may include:
Reducing Muscle Tension: Gentle soft tissue massage and myofascial release techniques for the tight calf muscles and plantar fascia (the band of tissue on the sole of the foot). This helps to decrease the pulling force on the growth plate.
Improving Joint Mobility: Gentle mobilisation of the ankle, foot, and even knee and hip joints to ensure balanced movement and reduce compensatory strains.
Addressing Biomechanics: Providing advice on activity modification, appropriate rest, and the use of ice to manage pain and inflammation. We can also offer guidance on supportive footwear.
Personalised Exercise Guidance: We will provide a tailored home program of specific stretches to improve calf flexibility and strengthening exercises for supportive muscle groups.
Education and Reassurance: We take time to explain the condition to both the parent and the child, empowering them with knowledge and practical strategies to manage the condition effectively.
When to Seek Further Medical Help
While osteopathy can be very effective, it is important to have a correct diagnosis from a healthcare professional. Please consult your GP or paediatrician for:
Severe, unrelenting pain that does not improve with rest.
Significant redness, warmth, or swelling that suggests infection.
Night pain that is not related to activity.
Numbness, tingling, or weakness in the foot.
If you are unsure about the diagnosis.
Supporting Your Active Child
Sever's Disease can be a frustrating hurdle for a passionate young athlete. Osteopathic care aims to help manage their symptoms, educate them about their body, and provide strategies to stay as active as possible while they heal. Our goal is to support their healthy development and love for movement.
Click here to schedule a gentle consultation for your child with one of our experienced osteopaths.
References
James, A. M., Williams, C. M., & Haines, T. P. (2013). Effectiveness of interventions in reducing pain and maintaining physical activity in children and adolescents with calcaneal apophysitis (Sever's disease): a systematic review. Journal of Foot and Ankle Research, 6(1), 16. [Link: https://jfootankleres.biomedcentral.com/articles/10.1186/1757-1146-6-16]
*The Royal Children's Hospital Melbourne. (2021). Heel pain - Sever's disease. [Link: https://www.rch.org.au/kidsinfo/fact_sheets/Heel_pain/]*
Smith, J. M., & Varacallo, M. (2023). Sever Disease. In StatPearls. StatPearls Publishing. [Link: https://www.ncbi.nlm.nih.gov/books/NBK441928/]
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner, such as your General Practitioner (GP) or paediatrician, for diagnosis and treatment of health conditions, especially in children. The information provided is for educational purposes and is based on the best available evidence. Osteopathic treatment is a complementary healthcare approach and works alongside conventional medicine. Individual results may vary.