Sever’s Disease (Calcaneal Apophysitis)

Tendons attach muscles to bone. The apophyses are the connections within growing bones. In this case, we are examining the connecting tissue between the heel bone (calcaneus), the growth plate that lies on the backside of the heel bone, and the Achilles tendon, which connects the calf muscles to the foot.

Because these mechanisms are involved and actively being used with every step we take, they are under constant stress. When the growth plate becomes inflamed and irritated, it essentially expands the apophyses, causing pain and tension in the back of the heel.

Predispositions

Sever’s disease is most commonly present in growing children ages 8-13. This often occurs in both feet, although it can only occur in one. Contributing factors to severity include, but are not limited to:

  • Growing children
  • Frequent running or jumping
  • Tight lower extremity muscles
  • History of plantar fasciitis

Symptoms

Patients often report experiencing the following symptoms:

  • Tightness in the calf
  • Pain in the heel
  • Tension in the plantar fascia

Because these symptoms can resemble other diagnoses (like tendonitis, or plantar fasciitis), seeking professional medical attention is strongly recommended upon discovering symptoms.

Treatment

After examining the patient, your podiatrist will advise one or more of the following:

  • Anti-inflammatory pain relieving medication
  • Rest
  • Activity modifications
  • Stretching
  • Physical therapy
  • A walking boot

Children will eventually outgrow the pain associated with Sever’s disease as the growth plate fuses.