The calcaneal apophysis is a growth center where the Achilles tendon and the plantar fascia attach to the heel. It first appears in children aged 7 to 8 years. By ages 12 to 14 years the growth
center matures and fuses to the heel bone. Injuries can occur from excessive tension on the Achilles tendon and the plantar fascia, or from direct impact on the heel. Excessive stress on this growth
center can cause irritation of the heel, also called Sever?s disease.
Sever?s Disease is thought to be caused by several reasons. Growth spurts. The muscles and tendons become tight due to rapid bone growth. Overuse. Sever?s Disease can also occur in children who are
athletically active and overwork his or her muscles. Some physicians are beginning to caution parents about checking their children?s shoes to make sure they fit well and do not pinch or put undue
pressure on the child?s feet. Pronation can also bring on Sever?s Disease.
Most children with Sever's complain of pain in the heel that occurs during or after activity (typically running or jumping) and is usually relieved by rest. The pain may be worse when wearing cleats.
Sixty percent of children's with Sever's report experiencing pain in both heels.
A Podiatrist can easily evaluate your child?s feet, to identify if a problem exists. Through testing the muscular flexibility. If there is a problem, a treatment plan can be create to address the
issue. At the initial treatment to control movement or to support the area we may use temporary padding and strapping and depending on how successful the treatment is, a long-term treatment plan will
be arranged. This long-term treatment plan may or may not involve heel raises, foot supports, muscle strengthening and or stretching.
Non Surgical Treatment
The simplest form of treatment is rest. Symptoms usually peak during activity. If the growth plate of the heel is allowed ample rest time and the amount of pressure is reduced, circumstances will
improve. To aid in decreasing pain and swelling, wrap the heel with an ice pack. Your podiatrists at Advanced Foot & Ankle of Arizona will provide you with the perfect guide to recovery. After
examination of the affected foot, time taken off from physical activity may be recommended. Stretching exercises and physical therapy will help strengthen the tendons and muscles surrounding the
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel.
Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and
inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a
cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence
of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle