Sever’s disease is the most common cause of heel pain in the adolescent. It affect boys more than girls and generally presents between the age of 8-12, although around 10-11 is the most common age. It will go away by itself, but often can be present for a long time.
The pain in Sever’s comes from the calcaneal growth plate (unfused area) at the rear of the calcaneus (heel) bone. The Achilles tendon and plantarfascia pull on this area during activity and with more activity comes more stress.
Unfortunately Sever’s (let’s skip the disease part – as it isn’t a disease at all) is often managed by forced reduction in activity, rather than proactive management. This means the young athlete is unable to take part in much of the sport and activity that they may potentially be able to do if better managed. Taping of the arch is particularly useful in most cases and can be taught to parents/coaches to assist in their child’s pain reduction.
Physiotherapy for Sever’s can include:
– a full assessment to rule out other contributors (muscle/bony imbalances, bone stress/fractures, non-musculoskeletal causes)
– pain relief (RICE)
– massage and stretching of the tight calf muscles
– taping of the arch to provide support for the arch and compression of the growth plate
– referral to doctor for pain relief or podiatrist for orthotic prescription
– occasional fixed ankle position walking boot
– gait (walking/running) education
– strengthening of the calf and arch muscles
– safe reloading exercises: jumping/hopping/running
– management/decision-making on safe levels of activity
The main aim of physiotherapy management is to see the young athlete through this time in their life where these type of problems are common and allow them to take as much of an active role in social activity and sports as possible.