What is the best treatment for Severs Disease of the Heel in Children?

Severs disease is the popular name for a problem referred to medically as calcaneal apophysitis. It genuinely should not be called Severs “disease” as it is not a disease. It is a self limiting condition of the growth plate in the heel bone of children that always goes away on its own sooner or later without having any long term problems. This is a quite common disorder in kids about age 10 to 12 years and should you question a group of kids of that age if they have it or have a friend that has had it, then a lot of them probably will say yes. There is a growth plate at the back of the heel bone in which growth of that heel bone occurs at. The achilles tendon connects to this growth plate, and so it is just not difficult to see that a lot of force is put on the growing area, particularly if the child is overweight or active in sport. The ailment is a stress of that growing area. The growing area combines with the remainder of the heel bone by the early teenage years, and so it is just not possible for it to become a issue beyond that.

Whilst Severs disease is self-limiting and they will outgrow this, it is painful and can cause discomfort so will have to be treated. The best approach is to focus on education in regards to the Severs disease and the ways to deal with exercise loads to keep it under control. It’s quite common to use ice on the heel after activity to help manage the pain. Cushioned gel heel pads are frequently good and might make it more bearable so they can continue with activity. If there are biomechanical issues, then proper foot supports may be needed to take care of that. The key part of the management is just handling the loads. Children of that age need to be active and get involved in sport, so this may be a nightmare and very diffcult to convince the child of that.

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