Sever's disease (heel pain in children)
Sever's disease is a common cause of heel pain in active children, and it affects the growth plate in the heel bone. Rest, footwear advice, orthotics, strapping and stretching programs can help. Fiona assesses and treats it in an initial consultation from $100.
What Sever's disease is
Sever's disease is a common cause of heel pain in children, particularly in those who are physically active. It involves inflammation of the growth plate in the heel bone. The condition usually develops just before puberty, and boys are slightly more prone to it than girls. Another name for it is traction calcaneal apophysis.
Symptoms
Symptoms of Sever's disease usually appear during or after sport. Your child may:
- complain of a sore heel near the end of activity
- limp or hobble off the field or court
- have pain in the heel or the ankle
Causes and risk factors
Causes and risk factors for Sever's disease centre on the load placed on the heel while it is still growing. The pain is believed to come from tractional forces that the Achilles tendon and the plantar fascia apply to the growth plate. Tight calf muscles can aggravate the pull. Feet that roll in too much when walking, a problem called overpronation, add to the strain, and so does poor foot posture. A high level of sport and activity can overload the growing heel.
Treatment at the clinic
Treatment at the clinic starts with an initial consultation from $100, where Fiona assesses your child's heel, the way they walk and the extent of the problem. She then sets a management plan, which may include rest or activity modification, footwear advice, strapping, and a stretching and strengthening program. Orthotics can help when overpronation is part of the problem. Custom orthotics, scanned with a 3D foot scanner, are from $650, including the biomechanical assessment, fitting and a review appointment. Semi-custom orthotics are from $450, including the biomechanical assessment and fitting. Fiona can refer your child for an X-ray, ultrasound or MRI when further checks are needed, and standard consultations are from $90.
Looking after it at home
Looking after it at home starts with rest from sport and activity. Do not encourage your child to exercise through the pain, because this can cause further damage to the heel. Keep up the exercises Fiona sets, and stick with the shoes she recommends at the consultation. Your child can return to sport as the heel settles, guided by Fiona's management plan.
When to see a podiatrist
See a podiatrist when your child often complains of sore heels around sport, or when the pain starts to change how they walk or play. Heel pain in children is not a normal part of growing up, so it is worth having the heel assessed. Fiona offers podiatry for children at Narre Warren and Cranbourne North. Take your child to a GP instead if the pain started with an injury, or if the heel is swollen, or if the pain is present at rest or at night, because another cause may need checking. Fiona can refer your child back to the GP when something outside podiatry needs attention.
Questions
How long does Sever's disease last?
Sever's disease settles once the growth plate in the heel bone closes, which happens as your child grows. Fiona re-assesses children who wear orthotics at that stage, to check whether the orthotics are still needed.
Does Sever's disease need surgery?
Surgery is not used to treat Sever's disease. Fiona manages the condition with conservative care and tailors the plan to your child.
Is Sever's disease just growing pains?
Sever's disease has a physical cause in the heel, so the pain should not be put down to growing pains without an assessment. The condition can be treated.