During AGS, and in specific reference to Sever?s disease, the heel bone grows faster than the Achilles tendon, resulting in an extremely tight Achilles tendon. Because the foot is one of the first
parts of the body to grow to full size, and because the heel is not a very flexible area, it is especially susceptible to injury. 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 (such as impact activities) on the tight Achilles tendon causes the tendon to pull on and damage the growth plate in
the heel, resulting in swelling, tenderness, and pain.
Sever?s disease is often an overuse injury. It can be caused by playing sports, especially those involving high impact. Sever?s disease can also be linked to growth which can place a stress on the
attachment of the Achilles tendon.
Sever's Disease is most commonly seen in physically active girls and boys from ages 10 to 15 years old. These are the years when the growth plate is still ""open,"" and has not fused into mature
bone. Also, these are the years when the growth plate is most vulnerable to overuse injuries, which are usually caused by sports activities. The most common symptoms of this disease include. Heel
pain in one or both heels. Usually seen in physically active children, especially at the beginning of a new sports season. The pain is usually experienced at the back of the heel, and includes the
following areas. The back of the heel (that area which rubs against the back of the shoe). The sides of the heel. Actually, this is one of the diagnostic tests for Sever's Disease, squeezing the rear
portion of the heel from both sides at the same time will produce pain. It is known as the Squeeze Test.
Low-grade inflammation of the calcaneal apophysis cannot be seen on x-ray. Therefore, although x-rays are often done to rule out bony injuries in children with Sever's disease these x-rays are
usually normal. Advanced Sever's disease can be seen on x-ray but usually the problem is treated before it reaches this point. Other diagnostic tests, such as bone scans or MRI's, are not usually
required in typical cases of Sever's disease. These, or other tests, may be required to rule out other conditions, such as stress fractures of the calcaneus or other bony abnormalities that can mimic
Non Surgical Treatment
For patients suffering from Sever's disease, the pediatric orthopaedic surgeon will often recommend a conservative treatment plan including anti-inflammatory medication (as directed by the doctor).
Application of ice to the heel. Calf, hamstring, and heel stretches. Orthotics. Modification of activities. There are rarely any complications with the treatment of Sever's disease, and symptoms
generally resolve within 2 weeks to 2 months. Patients can typically return to playing sports again after the heel pain has resolved. The physician will let confirm when it is safe to resume physical
Recovery time will vary from patient to patient. Age, health, previous injuries, and severity of symptoms will affect recovery time. Your compliance with the stretching program and the other
recommendations made by your doctor will also determine your healing time. Heel pain often completely resolves after a child?s heel bone has stopped its period of growth.