Sever’s disease

What is Sever’s disease?

Sever’s disease isn’t a disease; it’s an overuse injury of the heel. Usually heel pain begins after a few weeks of a running or jumping activity. Frequently, it’s children who participate in cross-country running, basketball or soccer who experience Sever’s.

The pain indicates swelling or inflammation in the heel. Your body is trying to tell you to slow down and let the muscles get used to the activity before working harder. The pain is caused by the pull of the Achilles tendon on the growth plate of the heel. In Sever’s disease, the heel looks normal but is tender to pressure, even walking.

X-rays appear normal in spite of the pain. The growth plate looks very white in color, and may even look cracked. This is normal, even in kids without pain. If X-rays are ordered, the health care provider may be looking for pain causes other than Sever’s.

Treatment

Treatment is based on reducing the swelling while continuing activity and sports — usually at a slower pace. Typically it takes a few weeks for the pain to go away.
Here are some things you can do to help relieve the pain:

  • Stretch – Stretch before and after activities to ease the pull of the Achilles on the heel. Stretching in the morning eases the pain that makes you want to walk on your toes.
  • Add a soft insert, or “heel cup” inside your shoe – This cradles the heel and absorbs pressure to help lessen the pain of impact.
  • Take ibuprofen – An hour or so before activity, take ibuprofen as directed for your child’s age. This can help pain and ease inflammation. Stronger medication should not be needed.
  • Ice – Applying ice 15 minutes after the activity will help ease pain until the body gets used to the new activity. Don’t forget to stretch after the activity as well.

Stretches to help ease pain with Sever’s disease

Hamstring stretches – Lie flat on the ground and lift one leg. Extend the knee fully with the leg perpendicular to the rest of your body. Hold the leg in place for a count of 20, then stretch the other leg. Repeat at least five times for each leg.

Sit on the ground with legs fully extended. Reach and grasp the toe of the left foot with the left hand. Hold for 20 seconds. Reach for the right toe with the right hand and hold for 20 seconds. Repeat at least five times each leg.

Achilles stretches – Sitting on the edge of a chair or floor, pull a towel tightly around one foot. Point and flex the toe against the tightly held towel five times. Hold each position for a count of five.

Repeat the stretches with the knee extended.

Stand and lean against the wall with one foot several inches in front of the other. Lean forward, keeping the back knee straight and bending the front knee. Keep the back foot heel on the floor. Repeat with each side at least five times.

The team

Joshua W. Meier, M.D.
Jennifer M. Brey, M.D.
Laura K. Jacks, M.D.
Star L. Nixon, M.D.
Kent L. Walker, D.O.
Sarah DuPlessis, PA-C
Andrea E. Ryan, PA-C
Wendy Luber, R.N.

Developmental-behavioral pediatrics and Genetics – 5347

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