A guide to Sever’s Disease: a condition which affects active children.

The winter sports season is underway! It's this time of year that we see a rise in the number of children visiting our clinic with Sever's disease.

Rugby and Football sideline chats amongst fellow parents about their children not performing on the field is often what prompts an appointment being booked to see us. Some kids are unable to keep up with their peers, others have a noticeably different run, but most are complaining of heel pain.

And while Sever's disease is a fairly common condition, there seems to be a lack of knowledge around it. This is especially true within the sporting community which it so heavily dominates at this time of year.

So what exactly is Sever's disease?

Despite its name, Sever's disease is not actually a disease, but rather a painful condition whereby the growth plate in the heel is inflamed. Also referred to as Calcaneal Apophysitis, it's a condition which affects growing active children, and is most common for those between the ages of eight and fourteen. It tends to present more in boys than girls, as they grow more quickly.

The pain or discomfort that children experience is a result of irritation to the growth plate at the back of the heel, which comes with age and maturing. As the heel bone develops, the muscles are unable to keep up with the growth rate of their bones, which naturally compromises their bone mechanics. As they are not getting the leverage they need through the ankle, the heel is loaded differently and starts to become irritated (damaged) and inflamed. 

While it can be difficult to prevent, there are a number of ways to help manage Sever’s disease and to avoid further discomfort. Running on hard surfaces and the like is best to stay away from, as it's the high impact on the heel bone itself that causes the inflammation to get worse. Often at the start of the Rugby and Football season, where there has been little rain, the hard grounds are a big contributor to the increase in the numbers of the condition presenting clinically. 

There are also better football boots than others for those with Sever’s disease. Football boot sales are often driven by fashion and celebrity marketing, but if your child has Sever’s disease it’s best they wear boots which are more supportive around the heel. Football boots are designed to have varying levels of cushion base in them. Children with the condition need their boots to have much more cushion in the base with a better quality midsole. A shoe brand that we recommend is Asics, as the pitch of the shoes they design is slightly different. This ensures that the load through the heel isn't as great and therefore works as a shock absorber and rear foot off-loader. 

If your child is complaining of heel pain, or you suspect they might have Sever’s disease, we highly recommend that you book an appointment with a podiatrist. An initial start to settle Sever’s disease would be to try some heel raises in their football boots and shoes. Rest, ice and elevating the foot will also help to avoid further discomfort.

We have a team of highly experienced podiatrists at Merivale Podiatry who can perform a comprehensive biomechanical assessment and create a tailored management plan for your child. Click here to visit our shop or book online.