In this section Cypress Foot and Ankle expert Dr. Christopher Correa discusses Seever's disease (Pediatric heel pain). Seever's disease (pediatric heel pain), also known as calcaneal apophysitis, is a common condition that affects children and adolescents. First off, it is my opinion that Seever's disease is not an accurate name as that it is not a disease at all. It is a type of overuse injury that occurs in the growth plate of the heel bone. The moniker Seever's disease makes the condition sound much worse than it really is and can needlessly induce fear in parents. Seever's is a self-limiting condition that will ultimately go away with the closure of the heel bone growth plate. Unfortunately, if the symptoms are not managed it can cause a reoccurring problem until skeletal maturity.
What is Seever's Disease (Pediatric heel pain)?
Growth plates are layers of cartilage in children that allow for the continued growth and expansion of bone until they reach skeletal maturity around the age of 14. The calcaneal growth plate is located at the back of the heel bone between the insertion of the Achilles tendon and main body of the heel bone . Seever's disease is inflammation of this growth plate secondary to repetitive high strain or direct injury. When the calf muscle contracts and pulls on the Achilles tendon it applies stress to both the heel bone and the growth plate. Since cartilage is weaker than both the tendon and bone the growth plate is where the highest levels of stress and sheer occur leading to pain and inflammation. Seever's disease is caused by repetitive stress on the heel, such as from playing sports or physical activity. Often times my patients participate in the same sport or a rotation of a few different sports year-round. This stress can cause small tears in the growth plate, leading to inflammation, pain, and swelling. The condition is most commonly seen in active children and adolescents, especially in those who play sports that involve running, jumping, and pivoting, such as soccer, basketball, and gymnastics.
Treatment for Sever's disease typically involves rest, ice, and pain relievers to reduce swelling and pain. Physical therapy and stretching exercises may also be prescribed to help strengthen the muscles and tendons in the affected area. In some cases, heel cups / lifts, orthotics or shoe inserts may be recommended to help redistribute pressure and relieve pressure on the heel. In rare severe cases, a cast or brace may be necessary to immobilize the foot and allow for proper healing. Surgery is not recommended for this condition as it will resolve when the growth plate closes near the end of puberty. For girls this is usually between age 13-15 and age 15-17 for boys. If your child is limping and complaining about heel pain, make an appointment with the experts at Select Foot and Ankle Specialists today and take the first step towards recovery!
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