The condition is more common in young people active in sport, and boys are more frequently affected than girls. One study found the average age of presentation was around 12 years for boys and 9
years for girls. In one prospective study of injuries among players aged 9-19 years in football academies, 2% of overall football injuries were due to Sever's disease; the peak for incidence was in
the under-11 age group. In a study of 85 children, the condition was bilateral in 61%.
During the growth spurt of early puberty, the heel bone (also called the calcaneus) sometimes grows faster than the leg muscles and tendons. This can cause the muscles and tendons to become very
tight and overstretched, making the heel less flexible and putting pressure on the growth plate. The Achilles tendon (also called the heel cord) is the strongest tendon that attaches to the growth
plate in the heel. Over time, repeated stress (force or pressure) on the already tight Achilles tendon damages the growth plate, causing the swelling, tenderness, and pain of Sever's disease. Such
stress commonly results from physical activities and sports that involve running and jumping, especially those that take place on hard surfaces, such as track, basketball, soccer, and
Athletes with Sever?s disease are typically aged 9 to 13 years and participate in running or jumping sports such as soccer, football, basketball, baseball, and gymnastics. The typical complaint is
heel pain that develops slowly and occurs with activity. The pain is usually described like a bruise. There is rarely swelling or visible bruising. The pain is usually worse with running in cleats or
shoes that have limited heel lift, cushion, and arch support. The pain usually goes away with rest and rarely occurs with low-impact sports such as bicycling, skating, or swimming.
Sever?s disease is diagnosed based on a doctor?s physical examination of the lower leg, ankle, and foot. If the diagnosis is in question, the doctor may order x-rays or an MRI to determine if there
are other injuries that may be causing the heel pain.
Non Surgical Treatment
Your child may need to change or stop doing the activities that cause pain until the growth plate heals. Your child needs to wear shoes with good padding in the heels and good arch support. Special
shoes or shoe inserts may help. Pain from Sever's disease may last weeks to months. The pain may come back if your child returns to sports or strenuous activities too soon.
To reduce the risk of heel pain or sore heels from Sever?s Disease. Only wear properly fitting shoes. A lace up shoe with a firm heel counter. Stretch calf and foot before exercising or playing
sports. Properly taping the foot provides excellent protection and immediate pain relief. Wear shoe inserts or an over-the-counter orthotic. If the problem persists, consult your foot doctor.