Sever's disease medically known as calcaneal apophysitis is a tractional apophysitis of the calcaneus seen in adolescence usually 8-13 years of age and tends to affect boys more than girls. It mostly affects adolescents involved in running sports such as soccer, rugby and tennis The growth plate of heel bone swells and inflames mainly due to growth spurts with the addition of poor foot mechanics.
Poor foot mechanics and pronatory forces coupled with the child's normal growth patterns places additional forces on the achilles tendon especially at the insertion site of the heel bone. This stress and tractional pull irritates the growth plate hence causing inflammation and pain. In severe cases, the apophysis or growth plate can actually detach and even fracture. This can cause serious disruption to the blood supply of the growth plate and in worse cases surgical intervention is required.
Severs disease is best diagnosed through X-ray. It can also be confirmed clinical with physical examination and special testing known as the 'calcaneal squeeze test'.
Conservative treatment involves the use of an orthotic device to remove the stress and strain caused by excess pronation. Other modalities used to aid in recovery include soft tissue massage, strapping of feet and foot mobilisation therapy.
In severe cases a heel lift addition is added to the orthotics to reduce achilles tendon strain. Participation in sports should be avoided for a period of 4-8 weeks on average depending on severity of condition. Immobilisation and partial to non weight bearing plaster casting is performed in the incidence of present fracture of calcaneal bone.