Watching a young footy player hobbling off the field is never a good sight to see. One of the most common problems often responsible for this is a type of heel pain known as Severs Disease.
Severs Disease or calcaneal apophysistis affects physically active boys aged 12 to 14 years and girls aged 10 to 12 years, which corresponds with the early growth spurts of puberty. Symptoms usually come on gradually and can include:
• Unilateral or Bilateral heel pain
• Heel pain during physical exercise, especially activities that require running or jumping
• Increased pain level after exercise
• A tender swelling or bulge on the heel that is painful on touch
• Calf muscle stiffness first thing in the morning
So what causes the pain?
During puberty the calcaneus or heel bone consists of two areas of bone known as ossification centres. These two areas are separated by an area of cartilage known as the calcaneal apophysis or growth plate. This growth plate does not fully fuse together until the foot has finished growing. The strongest tendon in the body the Achilles tendon attaches to the heel bone. It is through that as the body grows and the muscles become stronger the calf muscles that attach to the achilles tendon tighten up and cause more pulling strain around the growth plate on the heel bone. This often results in pain and sometimes inflammation which is known as Severs Disease.
The good news is that in the majority of cases Severs responds very well to treatment.
Treatment typically involves a stretching and or strengthening program to help stretch out the calf muscles and Achilles tendon. Ice is also recommended to help alleviate pain and is best placed over the painful area immediately after sport. The use of orthotics with a heel raise under both heels is also commonly prescribed and usually results in quick resolution of pain. In very active kids playing a couple of sports and training several times per week modifying their training load may also be required.
Podiatrists encounter cases of Severs disease daily especially during the footy season and know how best to diagnose and treat the problem. A my FootDr podiatrist will conduct a thorough assessment of the patient including a hands-on assessment of the painful area, video gait analysis of the way the patient is walking and running and an inspection of the patients shoes and footy boots. This will enable our podiatrist to accurately diagnose the problem and outline the best treatment approach for the individual.