Heel pain for the Foot and Ankle specialists is like the common cold for a primary care physician. The vast majority of the time it is diagnosed as plantar fasciitis and is on the bottom of the heel, usually at the instep. Though plantar fasciitis is common, heel pain can be from a variety of other diagnoses, including insertional achilles tendonitis, retrocalcaneal bursitis, or neuritis just to name a few. In adolescence, Sever’s disease, or calcaneal apohpysitis is the most common cause of heel pain.
Calcaneal Apophysitis or Sever’s disease is the most common diagnosis in athletically active youth between the ages of 6-13. Sever’s Disease, here after referred to as SD was initially described by Sever in 1912. Historically it was most often seen in adolescent boys who were involved in a variety of sporting activities. The usual presentation is pain in the back/bottom of the heel that is aggravated by activity and resolves to some extent with rest.
Sever’s Disease is an injury/irritation of a growth plate. The Calcaneal growth plate or growth plate in the heel bone has attachments from the achilles tendon and the plantar fascia. Pull from either or both of these structures can cause enough motion within the apophysis or growth plate space to create irritation and inflammation which can be quite painful and limiting.
The disease itself is self limiting and will resolve regardless of treatment once the growth plate has fully closed. Treatment is aimed at managing the pain as well as the inflammation. This is done with the rest, ice, non steroidal anti-inflammatories like ibuprofen, stretching, taping, heel cups, heel lifts and orthotics. In severe cases, cast or walking boot immobilization is used.
If you suspect your child has sever’s disease, consider scheduling an appointment at Texas Foot and Ankle Specialists. We are conveniently located adjacent to the La Centerra outdoor shopping center across from Cinco Ranch High School in the Katy area of west Houston. We have convenient hours to accommodate a variety of schedules and offer same day appointments for those with pressing needs.