SEVER’S DISEASE IN ADULTS AND CHILDREN

Image Credits: OrthoInfo – AAOS

“I have chosen to be happy because it is good for my health.”
-Voltaire

While orthopaedic conditions in children tend to be more severe in adults than in children, there are a few ailments that tend to plague children as they are growing and developing. One such condition is known as Sever’s Disease, a painful condition that affects the heels of children and adolescents. Also known as calcaneal apophysitis, Sever’s Disease occurs when there’s an inflammation of the heel’s growth plate. The image above gives a visual view of the heel anatomy, with the heel bone plated by the growth plate. With increased physical activity and even during growth spurts, children can experience pain in this region of the foot. 

As a disease that has the tendency to be induced by stress to the heel, if the stress is prolonged, the growth plate will be susceptible to the impact. Rapid changes to the heel anatomy will also induce damage to the growth plate. If your children are very active and in sports that have a lot of vertical motions that can cause stress to the heel, there will be an increased possibility of Sever’s Disease. At best, it will be in the best interest of the sufferer to minimize activities such as jumping and running, so that the heel itself can recover from the inflamed growth plate.

The growth plate is a growing area of bone in the foot anatomy. During the development process, the plate consists of cartilage, which then eventually develops into bone. The process continues until the child is fully formed as an adult. Growth plates then, are very soft compared to solid bone and with movements, will be impacted by the stresses of physical activity. Due to the proximity of the growth plate to the Achilles tendon, tendon stress can also impact the growth plate and induce inflammation. 

Heel pain, painful walking, heel swelling and general area tenderness is observed during an assessment of the area. Your orthopaedic specialist, will be able to relate the symptoms to the root cause during an examination. 

How Is Sever’s Disease Treated? 

Sever’s disease is usually treated by rest, rest and more rest. Based on the above root causes of physical stresses to the area, your child will be advised to minimize physical activity for a few weeks, depending on the severity of the condition. Once the growth plate has been restored, physical therapy will be utilized to ensure that the site is operating normally and to facilitate strength of the area. Foot inserts such as orthotics will be prescribed in order to ensure that the tender heel area is supported during the restorative process. 

Elevating the legs, as well as a routine stretching exercise can accelerate the healing process and prescribe a walking boot to protect the feet. Where necessary, your orthopaedic surgeon will prescribe anti-inflammatory drugs. These will include Nonsteroidal anti-inflammatory medication. Over the counter drugs like ibuprofen and naproxen can also be purchased to help reduce pain and swelling.

Reference Article: 

Sever’s Disease:https://orthoinfo.aaos.org/en/diseases–conditions/severs-disease/

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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